{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T23:56:12Z","timestamp":1778284572877,"version":"3.51.4"},"reference-count":24,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T00:00:00Z","timestamp":1707868800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bristol Myers Squibb and Pfizer Alliance"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Real-world evidence on direct oral anticoagulant outcomes among Non-Valvular Atrial Fibrillation (NVAF) patients is limited. We aimed to evaluate stroke\/systemic embolism (SE) and major bleeding (MB) risks among NVAF patients continuing or switching to different oral anticoagulants. Methods: Using Optum\u2019s de-identified Clinformatics\u00ae Data Mart Database, we identified NVAF patients initiating apixaban or rivaroxaban between 1 January 2013 and 31 December 2021. Patients switching therapies within 30 days before or 90 days after discontinuing their initial DOAC and those who continued initial therapy were included. The index date was the switch date for switchers, while continuers were assigned a hypothetic index date. Switchers and continuers were propensity score matched based on pre-index characteristics. Results: Among 167,868 apixaban and 65,888 rivaroxaban initiators, 2900 apixaban-to-rivaroxaban switchers were matched with 14,500 apixaban continuers, and 2873 rivaroxaban-to-apixaban switchers were matched with 14,365 rivaroxaban continuers. Apixaban-to-rivaroxaban switching was associated with higher stroke\/SE risk (HR: 1.99, 95% CI: 1.38\u20132.88) and MB risk (HR:1.80, 95% CI: 1.46\u20132.23) than continuing apixaban. Rivaroxaban-to-apixaban switching had similar stroke\/SE risk (HR: 0.74, 95% CI: 0.45\u20131.22) but lower MB risk (HR: 0.49, 95% CI: 0.38\u20130.65) than continuing rivaroxaban. Conclusions: These findings may aid physicians and patients in making informed decisions when considering a switch between apixaban and rivaroxaban.<\/jats:p>","DOI":"10.3390\/jcm13041073","type":"journal-article","created":{"date-parts":[[2024,2,14]],"date-time":"2024-02-14T06:59:26Z","timestamp":1707893966000},"page":"1073","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinical Impact of Switching or Continuation of Apixaban or Rivaroxaban among Patients with Non-Valvular Atrial Fibrillation"],"prefix":"10.3390","volume":"13","author":[{"given":"Steven","family":"Deitelzweig","sequence":"first","affiliation":[{"name":"Ochsner Clinic Foundation, New Orleans, LA 70121, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amiee","family":"Kang","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Lawrenceville, NJ 08648, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jenny","family":"Jiang","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Lawrenceville, NJ 08648, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chuan","family":"Gao","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Lawrenceville, NJ 08648, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuemei","family":"Luo","sequence":"additional","affiliation":[{"name":"Pfizer Inc., Groton, CT 06340, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nipun","family":"Atreja","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Lawrenceville, NJ 08648, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stella","family":"Han","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Lawrenceville, NJ 08648, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dong","family":"Cheng","sequence":"additional","affiliation":[{"name":"Bristol Myers Squibb, Lawrenceville, NJ 08648, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saarusri R","family":"Loganathan","sequence":"additional","affiliation":[{"name":"Mu Sigma Business Solutions Pvt. Ltd., Bangalore 560066, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"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 & Chest Hospital, Liverpool L14 3PE, UK"},{"name":"Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, 9220 Aalborg, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,14]]},"reference":[{"key":"ref_1","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":"Kornej","year":"2020","journal-title":"Circ. 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