Effectiveness and safety of oral anticoagulants for non-valvular atrial fibrillation: a population-based cohort study in primary healthcare in Catalonia

Objectives: Our objective was to analyse effectiveness and safety of oral anticoagulants (OAC) for stroke prevention in non-valvular atrial fibrillation. Material methods: Population-based cohort study including adults initiating anticoagulants, either direct (DOAC) or vitamin K antagonists (VKA), during 2011–2020. Data source: SIDIAP, capturing information from the electronic health records Primary Health Care Catalonia, Spain. Study outcomes: stroke, cerebral gastrointestinal (GI) haemorrhage, assessed by patients’ subgroups according different clinical characteristics. Results: We included 90,773 patients. Male sex, older than 75, previous event, peripheral artery disease, deep vein thrombosis, receiving antiplatelets, antidiabetics proton pump inhibitors (PPI) associated with higher risk. For DOAC-treated, treatment switch increased risk, while being adherent had a protective effect. Men, antidiabetic event risk bleeding. Receiving effect comparison antagonists. increased, adherence decreased bleeding people chronic kidney disease posed an bleeding, whereas PPI Conclusion: Being men, DOAC-switch all outcomes. against Adherence resulted lower found no differences when we compared vs.