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    Effectiveness and safety of rivaroxaban versus warfarin among nonvalvular atrial fibrillation patients with obesity and diabetes

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    Author
    Weir, Matthew R
    Chen, Yen-Wen
    He, Jinghua
    Bookhart, Brahim
    Campbell, Alicia
    Ashton, Veronica
    Date
    2021-09-04
    Journal
    Journal of Diabetes and Its Complications
    Publisher
    Elsevier Ltd.
    Type
    Article
    
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    See at
    https://doi.org/10.1016/j.jdiacomp.2021.108029
    Abstract
    Aims: To compare clinical outcomes of rivaroxaban and warfarin in patients with nonvalvular atrial fibrillation (NVAF) and concurrent obesity and diabetes. Methods: Patients aged ≥18 years were identified from a healthcare claims database with the following criteria: newly initiating rivaroxaban or warfarin, ≥1 medical claim with a diagnosis of AF, obesity determined by validated machine learning algorithm, and ≥1 claim with a diagnosis of diabetes or for antidiabetic medication. Treatment cohorts were matched using propensity scores and were compared for stroke/systemic embolism (SE) and major bleeding using Cox proportional hazards models. Results: A total of 9999 matched pairs of NVAF patients with obesity and diabetes who initiated treatment with rivaroxaban or warfarin were included. The composite risk of stroke/SE was significantly lower in the rivaroxaban cohort compared with the warfarin cohort (HR 0.82; 95% CI 0.74-0.90). Risks of ischemic and hemorrhagic strokes were also significantly reduced with rivaroxaban versus warfarin, but not SE. Major bleeding risk was similar between treatment cohorts (HR 0.92; 95% CI 0.78-1.09). Conclusions: In NVAF patients with comorbidities of obesity and diabetes, rivaroxaban was associated with lower risks of stroke/SE and similar risk of major bleeding versus warfarin.
    Rights/Terms
    Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.
    Keyword
    Anticoagulation
    Diabetes mellitus
    Nonvalvular atrial fibrillation
    Obesity
    Rivaroxaban
    Warfarin
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/16692
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jdiacomp.2021.108029
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