Comparing the safety and efficacy of two types of blood thinners in a primary care setting

Adults taking blood thinners, such as an anticoagulant Vitamin K antagonist medication like warfarin, were shown to have a lower incidence of overall bleeding events compared to those taking direct oral anticoagulants. However, the study also showed two times higher incidence of death in the VKA group. Researchers tracked 1,882 adult primary care patients treated with either VKA or DOAC in their usual primary care. Their doctors recorded incidences of significant bleeding events, blood clots and death over the course of one year. Researchers then compared health outcomes for the two drug groups using a matched propensity score model. The two groups had similar rates of serious adverse events, like blood clots and major bleeding, however the VKA group had a lower incidence of minor and non-major clinically significant bleeding. The two times higher incidence of death among patients taking VKAs aligns with prior analysis from health insurance data. The authors call for further research to explain the excess mortality with VKA.

Anticoagulants’ Safety and Effectiveness in General Practice: A Nationwide Prospective Cohort Study
Paul Frappe?, MD, PhD, et al
Jean Monnet University, Medicine Jacques Lisfranc, Department of General Practice, Saint-Etienne, France

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