Warfarin versus DOACs in the prevention of thromboembolic stroke in patients with Afib. : Warfarin versus DOACs in the prevention of thromboembolic stroke in patients with Afib.
Bibliographic record
Abstract
Purpose: Preventing thromboembolic (TE) events "such as stroke" is an essential part of managing patients with nonvalvular atrial fibrillation (Afib).Over the last 50 years, oral anticoagulant treatment with the Vitamin K Antagonist (VKA) Warfarin has played a crucial role in the secondary prevention of Stroke for Afib patients.Research suggests the new direct oral anticoagulant (DOACs) appears to have dominance over Warfarin for Afib treatment in the context of stroke prevention, and for the most part, superior to Warfarin in the secondary stroke prevention in patients with non-valvular Afib.Nevertheless, what does the evidence tell us about risk versus benefits?Method: This literature review conducts a systematic review of the advantages and disadvantages of DOACs, namely dabigatran, rivaroxaban, apixaban and edoxaban, compared with Warfarin in patients with (non-valvular) Afib.The review's search terms included Oral Anticoagulants, Anticoagulants, Direct Oral Anticoagulants, New Oral Anticoagulants, Warfarin, and secondary prevention non-valvular Afib, Afib, Stroke prevention and Stroke.The search resulted in sixty articles selected.Following a full-text review, twenty articles were excluded.The excluded articles included six non-English languages, eight previously identified, and six others did not fulfill the inclusion criteria of "Warfarin versus DOACs prevention of Stroke in Patients with Afib."The remaining articles were reviewed to analyze the advantages and disadvantages of DOACs versus Warfarin in patients in preventing TE stroke in people with non-valvular atrial fibrillation.Conclusion: The findings of this systematic literature review suggest that in the secondary prevention of stroke in patients with non-valvular Afib, DOACs, demonstrate a significant advantage and enhanced safety profile over Warfarin in reducing the risk of thromboembolic stroke compared with Warfarin.As such, DOACs should be considered first-line therapy in the secondary prevention of stroke in patients with non-valvular Afib.Compared with Warfarin, the advantages of DOACs indicated that DOACs are associated with lower life-threatening and intracranial bleeding rates.DOACs rapid onset with peak effect within a few hours, predictable dose responses, reduced or elimination of routine monitoring, and few, if any, important food or drug interactions, and simplify management.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.003 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".