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Activity Number: 323 - Estimating Treatment Effects: Applications in Health Policy
Type: Contributed
Date/Time: Wednesday, August 5, 2020 : 10:00 AM to 2:00 PM
Sponsor: Health Policy Statistics Section
Abstract #313778
Title: Safety and Effectiveness of Direct Oral Anticoagulants in Patients with Bioprosthetic Heart Valves and Atrial Fibrillation
Author(s): Lewei Duan* and Mingsum Lee
Companies: Kaiser Permanente Southern California and Kaiser Permanente
Keywords: Direct oral anticoagulants (DOACs) ; bioprosthetic valves; atrial fibrillation

A retrospective observational study is conducted using the Kaiser Permanente Southern California database to evaluate the effectiveness and safety of DOACs in patients with atrial fibrillation and bioprosthetic valves. All patients with bioprosthetic valves and a concomitant diagnosis of atrial fibrillation are included in the analysis. Anticoagulants prescribed (DOACs vs. warfarin) are identified using pharmacy dispensing records. Propensity scores matching is performed to balance demographics and clinical characteristics between DOACs patients and warfarin patients. Patients are evaluated for thromboembolic events and major bleeding events. Cox proportional hazards models are used to estimate the hazard ratios of mortality, thromboembolic events and major bleeding since therapy initiation. The result of the analysis is used to determine whether DOACs can be safely used in patients with bioprosthetic valves with an indication for anticoagulation.

Authors who are presenting talks have a * after their name.

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