Comparison of Safety, Efficacy and Usage of Direct Oral Anticoagulants and Their Associated Thromboembolism Risks among Cardiovascular Patients

The study aimed to evaluate and compare efficacy and safety of direct oral anticoagulants (DOACs) like dabigatran, rivaroxaban and apixaban and their thromboembolism episodes in terms of risks and types among patients on DOACs. This study also determined the correlation of demographic and clinical attributes on the thromboembolism episodes among patients on DOACs. A nonrandomized observational study was conducted on a cohort of DOACs using patients. The data of 201 patients using DOACs for various cardiovascular diseases was obtained from a public hospital. Descriptive and inferential statistics were applied using the Statistical Package for Social Sciences (SPSS) version 24.0. Univariate and multivariate analyses were performed to determine correlations of demographic and clinical attributes regarding safety and efficacy of DOACs. A p-value < 0.05 was considered statistically significant. The adjusted odd's ratios (OR) for ischemic stroke, TIA or systemic embolism were 0.428 (95%CI 0.051-3.601) for dabigatran, 0.757 (95%CI 0.118-4.845) for rivaroxaban and 1.648 (95%CI 0.267-10.190) for apixaban were observed. These results indicated a small difference in the thromboembolism risks between patients placed on different DOACs regimens, where apixaban group showed highest thromboembolism episodes. All DOACs were safe and effective but varied in response regarding thromboembolism episodes and risks.