{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,10]],"date-time":"2026-04-10T07:13:00Z","timestamp":1775805180266,"version":"3.50.1"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,2,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with hypertrophic cardiomyopathy (HCM) were excluded from pivotal trials comparing the efficacy and safety of direct oral anticoagulants (DOACs) and vitamin K antagonists.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Our retrospective cohort study using the TriNetX database compared adults with HCM\u2010atrial fibrillation who initiated DOACs or vitamin K antagonists. The primary outcomes were all\u2010cause mortality and ischemic stroke\/systemic thromboembolism. Secondary outcomes included major bleeding, intracranial hemorrhage, gastrointestinal bleeding, and all\u2010cause hospitalization. Subgroup analysis was conducted for obstructive HCM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 13\u2009143 patients with HCM\u2010atrial fibrillation (2963 matched pairs). DOAC use was associated with lower all\u2010cause mortality (hazard ratio [HR], 0.82[ 95% CI, 0.73\u20130.93];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001), major bleeding (HR, 0.85 [95% CI, 0.73\u20130.99];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.03), and intracranial hemorrhage (HR, 0.54 [95% CI, 0.36\u20130.79];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.001) compared with vitamin K antagonists. No differences were observed in the rates of ischemic stroke (HR, 0.94 [95% CI, 0.73\u20131.2];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.6) or the composite of stroke or systemic thromboembolism (HR, 0.87 [95% CI, 0.69\u20131.10];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.25), gastrointestinal bleeding (HR, 0.97 [95% CI, 0.77\u20131.22];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.82), or all\u2010cause hospitalizations (HR, 1.07 [95% CI, 0.93\u20131.07];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.051). In the subgroup with obstructive HCM, DOAC use was associated with a reduced risk of all\u2010cause mortality (HR, 0.80 [95% CI, 0.66\u20130.99];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.035) and major bleeding (HR, 0.76 [95% CI, 0.61\u20130.96];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.02) without stroke or thromboembolic risk reduction (HR, 0.69 [95% CI, 0.47\u20131.01];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Among patients with HCM\u2010atrial fibrillation, DOACs were associated with lower mortality and bleeding risk compared with vitamin K antagonists, with no increased risk of stroke or systemic thromboembolism.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.045998","type":"journal-article","created":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T10:58:32Z","timestamp":1770807512000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Direct\u2010Acting Oral Anticoagulants in Atrial Fibrillation With Hypertrophic Cardiomyopathy"],"prefix":"10.1161","volume":"15","author":[{"given":"Amro","family":"Taha","sequence":"first","affiliation":[{"name":"West Virginia University","place":["Morgantown, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6761-5390","authenticated-orcid":false,"given":"Avilash","family":"Mondal","sequence":"additional","affiliation":[{"name":"West Virginia University","place":["Morgantown, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4501-1005","authenticated-orcid":false,"given":"Usman Ali","family":"Akbar","sequence":"additional","affiliation":[{"name":"WVU Camden Clark Medical Center","place":["Parkersburg, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-4706-034X","authenticated-orcid":false,"given":"Aobo","family":"Li","sequence":"additional","affiliation":[{"name":"Inspira Medical Center","place":["Vineland, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2567-6651","authenticated-orcid":false,"given":"Harigopal","family":"Sandhyavenu","sequence":"additional","affiliation":[{"name":"University of Texas","place":["San Antonio, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Alhajji","sequence":"additional","affiliation":[{"name":"West Virginia University","place":["Morgantown, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5846-4620","authenticated-orcid":false,"given":"Sittinun","family":"Thangjui","sequence":"additional","affiliation":[{"name":"West Virginia University","place":["Morgantown, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0457-5851","authenticated-orcid":false,"given":"Harshith","family":"Thyagaturu","sequence":"additional","affiliation":[{"name":"West Virginia University","place":["Morgantown, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9677-8180","authenticated-orcid":false,"given":"Christopher","family":"Bianco","sequence":"additional","affiliation":[{"name":"West Virginia University","place":["Morgantown, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8534-0474","authenticated-orcid":false,"given":"Marco","family":"Caccamo","sequence":"additional","affiliation":[{"name":"West Virginia University","place":["Morgantown, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6390-6526","authenticated-orcid":false,"given":"Ahmad","family":"Masri","sequence":"additional","affiliation":[{"name":"Oregon Health and Science University School of Medicine","place":["Portland, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7872-3757","authenticated-orcid":false,"given":"Sudarshan","family":"Balla","sequence":"additional","affiliation":[{"name":"West Virginia University","place":["Morgantown, USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-020-0428-2"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-8703(44)91039-2"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/ejhf.316"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(01)01727-2"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.11.009"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.04.026"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2017.08.010"},{"key":"e_1_3_2_9_2","unstructured":"Real\u2010world data for the life sciences and healthcare|TriNetX. 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