- In patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (Afib), nonvitamin K antagonist oral anticoagulants (NOACs) were associated with lower risk for all-cause mortality and composite fatal cardiovascular events compared with warfarin.
- Risk for stroke and major bleeding was similar in patients receiving NOACs and warfarin.
Why this matters
- NOACs may be an effective alternative to warfarin, but there are limited data to support their use in patients with HCM and Afib.
- Warfarin-treated patients with HCM and Afib (n=955) were compared with a 1:2 propensity matched NOAC-treated patients (n = 1504).
- Primary outcomes: all-cause mortality, ischaemic stroke, major bleeding and acute myocardial infarction (MI).
- Secondary outcomes: composite of fatal cardiovascular events (fatal ischaemic stroke, bleeding and acute MI).
- Funding: Ministry of Education, Science and Technology and Health & Welfare.
- Warfarin vs NOAC-treated patients did not show any significant difference in the incidence of:
- ischaemic stroke (aHR, 0.94; P=.672).
- major bleeding (aHR, 0.97; P=.838).
- acute MI (aHR, 1.32; P=.263).
- Compared with warfarin, use of NOACs was significantly associated with lower risk for:
- all-cause mortality (aHR, 0.43; P<.001 and>
- composite of fatal cardiovascular events (aHR, 0.39; P=.013).
- Afib types were not defined.
- >50% NOAC-treated patients received reduced doses of NOACs.