NOACs May Be Better Choice for Patients With A-Fib and DM

For patients with atrial fibrillation (AF) and diabetes mellitus (DM), non-vitamin K antagonist oral anticoagulants (NOACs) are associated with lower risks for diabetes complications and mortality than warfarin, according to a study published online Feb. 15 in the Annals of Internal Medicine.

Huei-Kai Huang, M.D., from the National Taiwan University in Taipei, and colleagues conducted a retrospective cohort study to compare the risks for diabetes complications and mortality between patients with AF and DM receiving NOACs or warfarin between 2012 and 2017. Data were included for 19,909 NOAC users and 10,300 warfarin users.

The researchers found that the hazards of developing macrovascular complications, microvascular complications, glycemic emergency, and mortality were significantly lower for patients receiving NOACs than for those receiving warfarin (hazard ratios, 0.84, 0.79, 0.91, and 0.78, respectively). Similar results were seen in analyses with propensity score matching. The robustness of these findings was supported in several sensitivity analyses.

"NOAC may be a better therapeutic choice than warfarin for decreasing these complications and mortality in patients with AF and DM requiring oral anticoagulant treatment," the authors write. "Future prospective studies and randomized controlled trials are necessary to determine the causal relations."