Comparison of oral anticoagulants for stroke prevention in atrial fibrillation using the UK clinical practice research Datalink Aurum: A reference trial (ARISTOTLE) emulation study.
Emma Maud PowellUsha GungabissoonJohn TazareLiam SmeethParis J BaptisteTurki M Bin HammadAngel Yun WongIan J DouglasKevin WingPublished in: PLoS medicine (2024)
Analysis of noninterventional data generated results demonstrating noninferiority of apixaban versus warfarin consistent with prespecified benchmarking criteria. Unlike in ARISTOTLE, superiority of apixaban versus warfarin was not seen, possible due to the lower proportion of Asian patients and higher proportion of patients with well-controlled warfarin compared to ARISTOTLE. This methodological template can be used to investigate treatment effects of oral anticoagulants in patient groups excluded from or underrepresented in trials and provides a framework that can be adapted to investigate treatment effects for other conditions.
Keyphrases
- atrial fibrillation
- oral anticoagulants
- catheter ablation
- left atrial
- direct oral anticoagulants
- left atrial appendage
- heart failure
- clinical practice
- percutaneous coronary intervention
- end stage renal disease
- clinical trial
- ejection fraction
- chronic kidney disease
- newly diagnosed
- study protocol
- venous thromboembolism
- prognostic factors
- machine learning
- case report
- phase iii
- brain injury
- cross sectional
- coronary artery disease
- patient reported outcomes
- open label
- subarachnoid hemorrhage
- simultaneous determination
- acute coronary syndrome