When Atrial Fibrillation and Diabetes Coexist, How Best to Prevent Stroke?

February 15, 2017

In these complicated patients, should warfarin or a novel oral anticoagulant be chosen for stroke prevention?

In patients with atrial fibrillation (AF), comorbid type 2 diabetes (T2DM) is independently associated with a 2.5-3.0% increase in absolute stroke risk per year. T2DM also is an independent risk factor for both stroke and AF. Overlap in the pathophysiologies of these 2 important risk factors is not well understood nor do current practice guidelines provide evidence based recommdations on optimal management of patients with both conditions.In an effort to advance understanding of how best to manage stroke risk in the setting of AF and T2DM, Plitt and colleagues analyzed data on patients taken from the clinical trials to determine the safey and effiicacy of tne novel oral anticoagulants. Specifically, they were interested to see the differential efficacy of NOACs vs warfarin in preventing thromboembolism in this dually affected group.Results are higlighted in the slides above.