Effectiveness and Safety of Oral Anticoagulants among NVAF Patients with Obesity: Insights from the ARISTOPHANES Study Article

Full Text via DOI: 10.3390/jcm9061633 PMID: 32481607 Web of Science: 000549209600001
Open Access Industry Collaboration International Collaboration

Cited authors

  • Deitelzweig, Steve; Keshishian, Allison; Kang, Amiee; Dhamane, Amol D.; Luo, Xuemei; Li, Xiaoyan; Balachander, Neeraja; Rosenblatt, Lisa; Mardekian, Jack; Pan, Xianying; Di Fusco, Manuela; Reeves, Alessandra B. Garcia; Yuce, Huseyin; Lip, Gregory Y. H.


  • This ARISTOPHANES analysis examined stroke/systemic embolism (SE) and major bleeding (MB) among a subgroup of nonvalvular atrial fibrillation (NVAF) patients with obesity prescribed warfarin or non-vitamin K antagonist oral anticoagulants (NOACs) in order to inform clinical decision making. A retrospective observational study was conducted among NVAF patients who were obese and initiated apixaban, dabigatran, rivaroxaban, or warfarin from 1 January 2013-30 September 2015, with data pooled from CMS Medicare and four US commercial claims databases. Propensity score matching was completed between NOACs and against warfarin in each database, and the results were pooled. Cox models were used to evaluate the risks of stroke/SE and MB. A total of 88,461 patients with obesity were included in the study. Apixaban and rivaroxaban were associated with a lower risk of stroke/SE vs. warfarin (HR: 0.63, 95% CI: 0.49-0.82 and HR: 0.84, 95% CI: 0.72-0.98). Dabigatran was associated with a similar risk of stroke/SE compared to warfarin. Compared with warfarin, apixaban and dabigatran had a lower risk of MB (HR: 0.54, 95% CI: 0.49-0.61 and HR: 0.75, 95% CI: 0.63-0.91). Rivaroxaban was associated with a similar risk of MB compared to warfarin. In this high-risk population with obesity, NOACs had a varying risk of stroke/SE and MB vs. warfarin.

Publication date

  • 2020

Published in


  • 9


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