Exploring Internal Medicine by a Comparative Schematic Analysis of the Long-Term Outcomes of Anticoagulation Therapy

Wajiha Gul1, Sehrish Qaiser2, Syed Muzaffar Abbas3

  • 1General Internal Medicine, Midland Metropolitan University Hospital, Birmingham, GBR.

Cureus
|May 19, 2025
PubMed

Insights

Direct oral anticoagulants (DOACs) are effective for atrial fibrillation (AF) stroke prevention, showing better survival rates and fewer bleeding risks than warfarin. Further research is needed for long-term treatment guidelines.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Research

Background:

  • Atrial fibrillation (AF) increases stroke and cardiovascular risks.
  • Anticoagulation therapy is crucial for managing AF patients.
  • Long-term outcomes, stroke reduction, and bleeding hazards require ongoing evaluation.

Purpose of the Study:

  • To examine the long-term outcomes of anticoagulation therapy in AF patients.
  • To compare stroke prevention, bleeding risks, and survival rates of different anticoagulants.
  • To synthesize current evidence on anticoagulation in AF management.

Main Methods:

  • Systematic literature search across PubMed, Scopus, Web of Science, and Google Scholar (2015-2025).
  • Keywords: anticoagulation therapy, atrial fibrillation, stroke prevention, long-term outcomes, bleeding risks.
  • Quality assessment using Newcastle-Ottawa Scale, Cochrane Risk of Bias Tool, and GRADE approach for 12 included studies.

Main Results:

  • Direct oral anticoagulants (DOACs) demonstrated comparable or superior stroke prevention versus warfarin.
  • DOACs were associated with a lower incidence of major bleeding events.
  • Patients on DOACs exhibited improved survival rates compared to warfarin users.

Conclusions:

  • Anticoagulation therapy, particularly DOACs, shows significant clinical benefits for long-term AF management.
  • DOACs offer a favorable profile for stroke reduction and bleeding risk mitigation in AF.
  • Further long-term studies are essential to refine treatment guidelines and confirm DOAC efficacy versus warfarin.