Original Article

비판막성심방세동 환자에서 직접작용 경구용 항응고제 임상적 효과와 부작용 연구


Clinical outcomes of direct-acting oral anticoagulants compared to warfarin in patients with non-valvular atrial fibrillation

홍지원, 정민지, 이숙향

피인용수 : 0(자료제공 : 네이버학술정보)



Background: Non-valvular atrial fibrillation (NVAF) is associated with ischemic stroke risk in the aging population. Observational studies have indicated beneficial effects of direct-acting oral anticoagulant (DOAC) against ischemic stroke compared to warfarin. This study aimed to investigate ischemic stroke incidence and bleeding risk in patients on DOAC therapy. Methods: Using the database of Korean Health Insurance Review and Assessment-Aged Patient Sample 2015, we conducted a retrospective cohort study. Study subjects with NVAF diagnosis and prescribed anticoagulants were enrolled. Propensity score (PS) matching by age, sex, comorbidities, and medications were used. The clinical outcomes were major adverse cerebro-cardiovascular events (MACCEs, ischemic stroke/systemic embolism, myocardial infarction, cardiac death) and bleeding events. A cox proportional hazard model analysis was performed to compare the outcomes with hazard ratio (HR) and 95% confidence interval (CI). Results: Total 4,773 elderly patients with NVAF were initially included. Four PS-matched groups including rivaroxaban vs. warfarin-only (n=1,079), dabigatran vs. warfarin-only (n=721), rivaroxaban vs. dabigatran (n=721), and switchers of warfarin to rivaroxaban vs. warfarinonly (n=287) were analyzed. Every group showed statistically similar results of MACCEs and bleeding events, except for the group of rivaroxaban vs. dabigatran. Rivaroxaban users showed higher risks of bleeding events than dabigatran users (HR 2.25, 95% CI 1.01-4.99). Conclusion: In the elderly patients with NVAF, efficacy and safety outcomes among oral anticoagulants including DOACs and warfarin were similar, while rivaroxaban are more likely to have higher bleeding risks than dabigatran. Further research using large size sample is needed.


연구 방법
자료원 및 연구대상
기저질환 변수
결과 변수
통계적 분석
연구 결과
Rivaroxaban users vs. Warfarin-only users
Dabigatran users vs Warfarin-only users
Rivaroxaban users vs Dabigatran users
Switcher of warfarin to rivaroxaban (WR switcher) vs. Warfarin-only users


  • 홍지원 Jiwon Hong. 아주대학교 약학대학
  • 정민지 Minji Jung. 아주대학교 약학대학
  • 이숙향 Sukhyang Lee. 아주대학교 약학대학


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