Efficacy of low-dose non-vitamin K antagonist oral anticoagulants for stroke prevention in patients with nonvalvular at-rial fibrillation
Objective To compare the efficacy of low-dose dabigatran,rivaroxaban and edoxaban for stroke pre-vention in patients with nonvalvular atrial fibrillation(NVAF).Methods A retrospective analysis was performed on patients with NVAF who were hospitalized in the Department of Cardiology,Renmin Hospital of Wuhan Univer-sity from March 2021 to November 2022.According to the non-vitamin K antagonist oral anticoagulant(NOAC),the patients were divided into dabigatran group,rivaroxaban group and edoxaban group.The general data,incidence of embolization events and bleeding events of the three groups were compared.Results A total of 360 patients were selected,with 120 patients in each group.The average follow-up period was 11.1 months,There were 6 efficacy endpoints in dabigatran group and rivaroxaban group,and 4 efficacy endpoints in edoxaban group.There was no sig-nificant difference between the three groups(P＞0.05).There were 16 safety endpoints in the dabigatran group,in-cluding 6 gastrointestinal bleeding,20 safety endpoints in the rivaroxaban group,including 10 gastrointestinal bleed-ing,and 17 safety endpoints in the edoxaban group,including 3 gastrointestinal bleeding.Although there was no significant difference in the incidence of total bleeding among the three groups(P＞0.05),the incidence of gastroin-testinal bleeding in rivaroxaban group was significantly higher than that in edoxaban group[8.3％(10/120)vs 2.5％(3/120),P＞0.05].Conclusion The efficacy of low-dose NOAC for stroke prevention in NVAF patients is similar.Although the total bleeding risk is comparable between low-dose NOAC,edoxaban has a lower risk of gastrointestinal bleeding than rivaroxaban.[Chinese Journal of Cardiac Pacing and Electrophysiology,2024,38(3):171-174]
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