Table 3.
Incidence Rates and Results of Cox Proportional Hazards Models Comparing Matched DOAC and Warfarin Groups Overall and by Time Period
| Apixaban versus warfarin | |||||||
| 2013–2016 | 2015–2016 | 2013–2014 | |||||
| Overall (n = 5762) | Apixaban (n = 2333) | Warfarin (n = 2333) | Apixaban (n = 548) | Warfarin (n = 548) | |||
| HR (95% CI) | No. of events (rate per 100 PYs) | HR (95% CI) | No. of events (rate per 100 PYs) | HR (95% CI) | |||
| Ischemic stroke/TIA† | 1.86 (1.00–3.45) | Suppressed per DUA | Suppressed per DUA | 2.71 (1.21–6.06) | Suppressed per DUA | Suppressed per DUA | 0.89 (0.31–2.55) |
| Bleeding | 0.66 (0.49–0.88) | 61 (5.18) | 78 (7.18) | 0.73 (0.52–1.02) | 17 (2.77) | 30 (5.81) | 0.49 (0.27–0.89) |
| AMI/VTE/SE† | 0.70 (0.46–1.05) | Suppressed per DUA | Suppressed per DUA | 0.89 (0.55–1.43) | Suppressed per DUA | Suppressed per DUA | 0.36 (0.16–0.83) |
| Mortality | 0.78 (0.70–0.88) | 407 (37.29) | 468 (39.60) | 0.81 (0.71–0.93) | 147 (23.70) | 180 (34.52) | 0.70 (0.57–0.88) |
| Composite | 0.79 (0.71–0.88) | 495 (27.58) | 551 (30.70) | 0.84 (0.74–0.95) | 168 (27.38) | 216 (41.86) | 0.67 (0.55–0.82) |
| Dabigatran versus warfarin | |||||||
| 2011–2016 | 2014–2016 | 2011–2013 | |||||
| Overall (n = 2578) | Dabigatran (n = 378) | Warfarin (n = 378) | Dabigatran (n = 911) | Warfarin (n = 911) | |||
| HR (95% CI) | No. of events (rate per 100 PYs) | HR (95% CI) | No. of events (rate per 100 PYs) | HR (95% CI) | |||
| Ischemic stroke/TIA† | 0.92 (0.51–1.65) | Suppressed per DUA | Suppressed per DUA | NE | Suppressed per DUA | Suppressed per DUA | 0.87 (0.47–1.58) |
| Bleeding | 1.10 (0.80–1.53) | 16 (6.19) | 17 (6.66) | 0.93 (0.47–1.84) | 54 (6.04) | 56 (4.96) | 1.16 (0.80–1.69) |
| AMI/VTE/SE | 0.66 (0.40–1.09) | 16 (1.79) | 31 (2.74) | 0.69 (0.29–1.61) | 130 (21.93) | 160 (30.69) | 0.65 (0.35–1.18) |
| Mortality | 0.68 (0.59–0.79) | 212 (23.48) | 398 (34.42) | 0.71 (0.53–0.97 | 71 (27.25) | 98 (38.12) | 0.67 (0.57–0.79) |
| Composite | 0.76 (0.67–0.87) | 280 (31.28) | 454 (40.24) | 0.78 (0.59–1.02) | 92 (35.57) | 117 (45.83) | 0.76 (0.65–0.88) |
| Rivaroxaban versus warfarin | |||||||
| 2011–2016 | 2014–2016 | 2011–2013 | |||||
| Overall (n = 7470) | Rivaroxaban (n = 2832) | Warfarin (n = 2832) | Rivaroxaban (n = 903) | Warfarin (n = 903) | |||
| HR (95% CI) | No. of events (rate per 100 PYs) | HR (95% CI) | No. of events (rate per 100 PYs) | HR (95% CI) | |||
| Ischemic stroke/TIA | 1.09 (0.73–1.63) | 34 (1.89) | 23 (1.29) | 1.48 (0.87–2.51) | 16 (1.75) | 23 (2.46) | 0.71 (0.38–1.34) |
| Bleeding | 1.07 (0.87–1.33) | 118 (6.58) | 123 (6.88) | 0.96 (0.74–1.23) | 57 (6.22) | 41 (4.39) | 1.42 (0.95–2.13) |
| AMI/VTE/SE | 0.91 (0.67–1.24) | 62 (3.46) | 56 (3.13) | 1.10 (0.77–1.58) | 14 (1.53) | 28 (3.00) | 0.52 (0.27–0.98) |
| Mortality | 0.79 (0.72–0.87) | 563 (31.17) | 709 (39.15) | 0.80 (0.71–0.89) | 261 (28.18) | 343 (36.00) | 0.78 (0.60–0.92) |
| Composite | 0.86 (0.79–0.94) | 725 (40.40) | 830 (46.39) | 0.87 (0.79–0.96) | 324 (35.36) | 393 (42.08) | 0.84 (0.73–0.97) |
Matched on propensity scores that were estimated using the following variables: age, sex, cognitive status, functioning in activities of daily living, CHA2DS2-Vasc score, ATRIA score, number of recent hospitalizations, recent ischemic stroke hospitalization, recent TIA hospitalization, recent AMI hospitalization, recent systemic embolism hospitalization, recent extracranial bleed hospitalization, recent intracranial hemorrhage hospitalization, renal functioning, recent fall, hip fracture, coronary artery disease, peripheral vascular disease, anemia, diabetes, heart failure, hypertension, stroke, hemiplegia, aphasia, use of ACE inhibitors/ARBs, NSAID use, antiplatelet use, statin use, selective serotonin reuptake inhibitor use, and number of unique medications
†Cell sizes suppressed so that no cell was < 11 per data use agreement
TIA transient ischemic attack, AMI acute myocardial infarction, VTE venous thromboembolism, SE systemic embolism, NE not estimable, HR hazard ratio, CI confidence interval, DOAC direct-acting oral anticoagulant, DUA data use agreement