Better clinical outcome with direct oral anticoagulants in hospitalized heart failure patients with atrial fibrillation

摘要

Atrial fibrillation (AF) is common in patients with heart failure and is associated with higher mortality. Although previous studies have reported that direct oral anticoagulants (DOACs) reduce the risk of cardiovascular events in out-patients with AF, it remains unclear whether DOACs reduce mortality in hospitalized heart failure (HHF) patients with AF. Therefore, we examined the impact of DOACs on mortality in this group of patients. Consecutive 497 HHF patients with AF were retrospectively registered and divided into three groups on the basis of the presence of anticoagulant therapy: non-anticoagulant group (Non, n?=?90), Vit K antagonists (VKAs) group (n?=?257) and DOACs group (n?=?150). We followed up all the patients for mortality. In the Kaplan-Meier analysis (mean follow-up of 1093?days), all-cause mortality was significantly lower in the VKAs and DOACs groups than in the Non group (31.1% and 15.3% vs. 43.3%, log-rank P?