Non-valvular atrial fibrillation (NVAF) is the most common cardiac arrhythmia, and this condition constitutes a major indication for oral anticoagulant therapy. NVAF is particularly common in diabetic patients, who are at greater risk of developing thrombotic or bleeding complications. Direct oral anticoagulants (DOACs) are progressively replacing vitamin K antagonists (VKAs) among patients with NVAF. They are as effective as VKAs in reducing the risk of cerebral and systemic embolic events, while simultaneously decreasing severe and cerebral bleedings. Several recent studies have demonstrated DOACs to provide the same benefits in terms of efficacy and safety in diabetic versus non-diabetic subjects with NVAF. As suggested by the results of the ENGAGE AF-TIMI 48 study, among the DOACs, edoxaban given to diabetic NVAF patients appears to be associated with a significantly decreased risk of severe bleeding complications compared with VKAs.
Key Words
Direct oral anticoagulants, atrial fibrillation, diabetes, edoxaban