Estimating the Stroke Risk Threshold for Initiating Non-Vitamin K Antagonist Oral Anticoagulation in Atrial Fibrillation: Markov Decision Model Analysis.

ABSTRACT:

Background

Randomized trials have clearly demonstrated the benefits of anticoagulant therapy in patients with atrial fibrillation who are at high risk of ischemic stroke. However, less is known about the benefit of anticoagulation in low-risk patients, and exactly how low baseline stroke risk justifies further attempts to reduce it with direct oral anticoagulants (DOACs) remains unclear.

Methods

We developed a Markov decision model to estimate the impact of initiating DOACs on quality-adjusted life years (QALYs) on a 20-year time horizon in patients with atrial fibrillation across a range of nonanticoagulated ischemic stroke risk. The model incorporated data from randomized controlled trials on the effects of DOACs on the severity and risk of ischemic stroke, major bleeding,

SUBMITTER: Winsten AK 

PROVIDER: S-EPMC12442775 | biostudies-literature | 2025 Sep

REPOSITORIES: biostudies-literature