Study of safety and efficacy outcomes of doacs vs conventional oral anticoagulation in patients with mitral stenosis

Background: AF is associated with risk of thromboembolism events. DOACs are effective in preventing thromboembolism among AF patients. However patients with moderate to severe MS have been excluded from all pivotal studies. Warfarin remains only oral anticoagulants in such patients Aim of the Study: To validate efficacy and safety of DOACs vs COACs (Warfarin) in patients with mitral stenosis with Atrial fibrillation irrespective of severity of mitral stenosis. Material & Methods: The study was in 150 patients with rheumatic heart disease with mitral stenosis with AF regardless of severity. Prospective and hospital based study. Results: Among patients on DOACs 97.3% (36/37) treated with dabigatran and in conventional oral anticoagulation (COACs) 37.83% (14/37) and 62.14% (23/37) patients on warfarin and acenocoumarol respectively. Among COACs (warfarin) group two i.e.(5.4%)patients were developed ischemic stroke during follow up which was statistically insignificant as compared to DOACs group, in which no patient were developed ischemic stroke. Among COACs (warfarin) two patients i.e. 5.4% developed other bleeding manifestations such as nasal or gum bleeding and one patient i.e.2.7% patients developed other bleeding manifestations such gum bleeding which is statistically insignificant.