{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T12:55:55Z","timestamp":1793451355803,"version":"4.5.0"},"reference-count":42,"publisher":"Georg Thieme Verlag KG","issue":"01","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thromb Haemost"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:p>\n            Background\u2003Atrial fibrillation (AF) Better Care (ABC) pathway adherence is associated with improved outcomes. Clinical trials have shown that non-vitamin K antagonist oral anticoagulants (NOACs) are as least as effective as warfarin for stroke prevention in AF patients. The Win Ratio method, analyzing hierarchical composite outcomes considering event timing and severity, has limited data on its use in Asians.<\/jats:p><jats:p>\n            Objectives\u2003We aim to apply Win Ratio in a registry to access the comparative effectiveness of NOACs versus warfarin and ABC adherence versus nonadherence in Asian patients with AF.<\/jats:p><jats:p>\n            Methods\u2003Our study included nonvalvular AF patients from the nationwide prospective COOL-AF registry in Thailand. The NOAC-treated group was compared with the warfarin-treated group using the Win Ratio, with the following order: all-cause death, intracranial hemorrhage (ICH), ischemic stroke\/transient ischemic attack\/systemic embolism, non-ICH major bleeding, and myocardial infarction or heart failure. ABC pathway adherence versus nonadherence was also compared. A Win Ratio greater than 1.00 indicating a better outcome.<\/jats:p><jats:p>\n            Results\u2003The analysis included 2,568 patients, with 228 in the NOAC group and 2,340 in the warfarin group. The NOAC group had more wins than the warfarin group, with an unmatched Win Ratio of 1.64 (95% confidence interval [CI]: 1.22\u20132.20; p\u2009&lt;\u20090.001). When compared with nonadherence, ABC pathway adherence was associated with a Win Ratio of 1.57 (95% CI: 1.33\u20131.85; p\u2009&lt;\u20090.001).<\/jats:p><jats:p>\n            Conclusion\u2003This Win Ratio analysis demonstrates the significant benefits of NOACs over warfarin and ABC pathway adherence over nonadherence in reducing the composite outcome in patients with AF.<\/jats:p>","DOI":"10.1055\/s-0043-1772773","type":"journal-article","created":{"date-parts":[[2023,8,25]],"date-time":"2023-08-25T23:12:49Z","timestamp":1693005169000},"page":"069-079","source":"Crossref","is-referenced-by-count":83,"title":["Non-vitamin K Antagonist Oral Anticoagulant, Warfarin, and ABC Pathway Adherence on Hierarchical Outcomes: Win Ratio Analysis of the COOL-AF Registry"],"prefix":"10.1055","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4248-2066","authenticated-orcid":false,"given":"Sukrit","family":"Treewaree","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom"},{"name":"Department of Clinical Medicine, Danish Center for Clinical Health Services Research, Aalborg University, Aalborg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rungroj","family":"Krittayaphong","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2023,8,25]]},"reference":[{"issue":"02","key":"ref1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/1747493019897870","article-title":"Global epidemiology of atrial fibrillation: an increasing epidemic and public health challenge","volume":"16","author":"G Lippi","year":"2021","journal-title":"Int J Stroke"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1161\/CIRCRESAHA.120.316340","article-title":"Epidemiology of atrial fibrillation in the 21st century: novel methods and new insights","volume":"127","author":"J Kornej","year":"2020","journal-title":"Circ Res"},{"issue":"05","key":"ref3","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1093\/eurheartj\/ehaa612","article-title":"2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC","volume":"42","author":"G Hindricks","year":"2021","journal-title":"Eur Heart J"},{"issue":"01","key":"ref4","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1055\/s-0041-1739411","article-title":"2021 focused update consensus guidelines of the Asia Pacific Heart Rhythm Society on Stroke Prevention in Atrial Fibrillation: executive summary","volume":"122","author":"T F Chao","year":"2022","journal-title":"Thromb Haemost"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1055\/a-1515-9630","article-title":"Adherence to the 'Atrial Fibrillation Better Care' pathway in patients with atrial fibrillation: impact on clinical outcomes-a systematic review and meta-analysis of 285,000 patients","volume":"122","author":"G F Romiti","year":"2022","journal-title":"Thromb Haemost"},{"issue":"06","key":"ref6","first-page":"1087","article-title":"Vitamin K antagonists in heart disease: current status and perspectives (Section III). 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