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September 10, 2025Frontiers in PharmacologyOpen Access

Comparative clinical outcomes of acenocoumarol versus direct oral anticoagulants (DOACs) and warfarin in patients with atrial fibrillation: real-world-evidence (SIESTA-A study)

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Authors

MMMa Carmen Montero-BalosaJLJuan A Limón-MoraALAna Leal-Atienza

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Overview

Retrospective analysis of anticoagulants shows DOACs may reduce bleeding risk in atrial fibrillation patients, implying varied efficacy.

Key Points

  • Compared to acenocoumarol, dabigatran, rivaroxaban, and apixaban were linked to lower all-cause mortality rates.
  • DOACs generally demonstrated a lower risk of intracranial bleeding, while warfarin was associated with both increased bleeding and less effectiveness.
  • Effectiveness was assessed using survival models including Cox regression and Kaplan-Meier curves, supporting the findings.
  • The analyses suggest that while DOACs offer safety advantages, they do not significantly reduce thromboembolic events relative to acenocoumarol.

Cite This Study

Montero-Balosa et al. (2025) studied this question.

synapsesocial.com/papers/68c23ed7b210217d647949c2https://doi.org/10.3389/fphar.2025.1548298
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1From prescription to outcome: real-world utilization of direct oral anticoagulants in atrial fibrillation across Europe2026
  2. 2Comparative Analysis of Newer Oral Anticoagulants in the Management of Coronary Artery Disease: Safety and Efficacy in an Intensive Care Setting2025
  3. 32188-P: Clinical Benefits and Risks of Reduced-Dose vs. Standard-Dose Direct Oral Anticoagulants in Patients with Atrial Fibrillation: An Observational Analysis of Veterans Affairs Data2026
  4. 4Comparative outcomes of direct oral anticoagulants versus warfarin in patients with atrial fibrillation and liver cirrhosis: A propensity score matched TriNetX analysis2026
  5. 5Efficacy and safety of oral anticoagulants in the treatment of chronic kidney disease with atrial fibrillation or venous thromboembolism: a systematic review and meta-analysis2025 · 8 citations