Top

Published in:

01-07-2018

More efficacious, equally safe: a meta-analysis comparing the safety of direct oral anticoagulants versus aspirin

Authors: Jeffrey Y. Bien, MD, Derrick L. Tao, Molly M. Daughety, Thomas G. DeLoughery, Joseph J. Shatzel

Published in: Journal of Thrombosis and Thrombolysis | Issue 1/2018

Excerpt

Whether aspirin carries a favorable safety profile compared to direct oral anticoagulants (DOACs) remains a topic of controversy. A recent study by Hsu et al. illustrates how providers often preferentially choose aspirin for patients they perceive to be at high risk of bleeding, noting that over 38% of patients who qualify for additional anticoagulation per guidelines are actually managed on aspirin alone in real life practice [1]. …

Hsu JC, Maddox TM, Kennedy K et al (2016) Aspirin instead of oral anticoagulant prescription in atrial fibrillation patients at risk for stroke. J Am Coll Cardiol 67:2913–2923. https://doi.org/10.1016/j.jacc.2016.03.581 CrossRefPubMed

Mant J, Hobbs FR, Fletcher K et al (2007) Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham Atrial Fibrillation Treatment of the Aged Study, BAFTA): a randomised controlled trial. Lancet 370:493–503. https://doi.org/10.1016/S0140-6736(07)61233-1 CrossRefPubMed

Chai-Adisaksopha C, Crowther M, Isayama T, Lim W (2014) The impact of bleeding complications in patients receiving target-specific oral anticoagulants: a systematic review and meta-analysis. Blood 124:2450–2458. https://doi.org/10.1182/blood-2014-07-590323 CrossRefPubMed

Weitz JI, Lensing AWA, Prins MH et al (2017) Rivaroxaban or aspirin for extended treatment of venous thromboembolism. N Engl J Med 376:1211–1222. https://doi.org/10.1056/NEJMoa1700518 CrossRefPubMed

Connolly SJ, Eikelboom J, Joyner C et al (2011) Apixaban in patients with atrial fibrillation. N Engl J Med 364:806–817. https://doi.org/10.1056/NEJMoa1007432 CrossRefPubMed

January CT, Wann LS, Alpert JS et al (2014) 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation 130:2071–2104. https://doi.org/10.1161/CIR.0000000000000040 CrossRefPubMed

Kearon C, Akl EA, Ornelas J et al (2016) Antithrombotic therapy for VTE disease: chest guideline and expert panel report. Chest 149:315–352. https://doi.org/10.1016/j.chest.2015.11.026 CrossRefPubMed

Title: More efficacious, equally safe: a meta-analysis comparing the safety of direct oral anticoagulants versus aspirin
Authors: Jeffrey Y. Bien, MD
Derrick L. Tao
Molly M. Daughety
Thomas G. DeLoughery
Joseph J. Shatzel
Publication date: 01-07-2018
Publisher: Springer US
Published in: Journal of Thrombosis and Thrombolysis / Issue 1/2018
Print ISSN: 0929-5305
Electronic ISSN: 1573-742X
DOI: https://doi.org/10.1007/s11239-018-1648-8

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Pediatric Cardiology Video

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

Cardiopulmonary Comorbidity Video

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Valvular Heart Disease Video

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Heart Failure Video

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

ACC 2024 Congress Coverage

Heart Failure Video

Year in Review: Heart failure and cardiomyopathies

Watch now

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.

Semaglutide benefits people with type 2 diabetes and obesity-related heart failure

16-04-2024 Type 2 Diabetes News

Incentivised to exercise

11-04-2024 Lifestyle Modifications News

New intervention for STEMI-related cardiogenic shock

10-04-2024 Myocardial Infarction News

» View more highlights on the ACC 2024 congress hub page

Image Credits

STEP AAG HeroTeaserCollection image/© Tarek / Generated with AI / Stock.adobe.com, ACC 2024 Pediatric and Congenital Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Pulmonary Vascular Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 Valvular Heart Disease: Year in Review/© 2024 American College of Cardiology, ACC 2024 HF and Cardiomyopathies: Year in Review/© 2024 American College of Cardiology, Woman out walking/© Seventyfour / stock.adobe.com (symbolic image with model), Woman checking smartwatch /© saltdium / stock.adobe.com (symbolic image with model), Cardiac catheterization/© Damian / stock.adobe.com

At a glance: The STEP trials

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 1/2018

Treatment of submassive and massive pulmonary embolism: a clinical practice survey from the second annual meeting of the Pulmonary Embolism Response Team Consortium

Evaluation and management of thromboprophylaxis in Moroccan hospitals at national level: the Avail-MoNa study

PFO closure for secondary stroke prevention: is the discussion closed?

Hospital length of stay in patients initiated on direct oral anticoagulants versus warfarin for venous thromboembolism: a real-world single-center study

Quality of direct oral anticoagulant prescribing in elderly patients with non-valvular atrial fibrillation: results from a large urban health system

Interaction between nonsynonymous polymorphisms in PLA2G7 gene and smoking on the risk of coronary heart disease in a Chinese population

Highlights from the ACC 2024 Congress

ACC 2024 Congress Coverage