直接口服抗凝剂（DOAC）在心房颤动（AF）患者的血管和出血事件方面优于华法林。然而，DOAC 对充血性心力衰竭 (CHF) 和阿尔茨海默病 (AD) 的影响仍鲜有研究。利用台湾国民健康保险研究数据库，进行了一项全国性回顾性队列研究。该研究将 5,683 名非瓣膜性房颤 (NVAF) 依多沙班患者与 11,366 名华法林患者进行匹配，将 703 名非瓣膜性心房颤动 (NVAF-C) 依多沙班患者与 1,406 名华法林患者进行匹配。比较了艾多沙班和华法林使用者之间的血管和非血管结局，重点是 CHF 和 AD。艾多沙班显着降低了全因死亡率、胃肠道出血住院和 CHF 的调整风险比 (aHR)（0.37、0.74、与华法林相比，NVAF 中分别为 0.39、0.67 和 0.31；NVAF-C 中分别为 0.39、0.67 和 0.31，所有 p < 0.05）。与华法林相比，艾多沙班与 NVAF 患者的急性心肌梗死、外周动脉疾病、静脉血栓栓塞、肺栓塞和 AD 的 aHR 显着降低相关（分别为 0.71、0.48、0.55、0.20 和 0.66；所有 p < 0.05）。然而，在 NVAF 患者中，艾多沙班的住院出血 aHR 较高（1.19，p = 0.002），但在 NVAF-C 患者中则不然。艾多沙班可降低 NVAF 和 NVAF-C 患者的 CHF 风险，并减少 NVAF 患者的 AD 发生率患者与华法林。这些研究结果支持在房颤病例中使用艾多沙班。最新消息：研究表明，在房颤 (AF) 患者中，艾多沙班（一种直接口服抗凝剂 (DOAC)）比华法林具有显着优势。值得注意的是，与华法林相比，艾多沙班可降低充血性心力衰竭 (CHF) 和阿尔茨海默病 (AD) 的风险。临床意义？：这些发现具有重要的临床意义。对于 AF 患者来说，艾多沙班似乎是一种更好的抗凝药物，因为它可以降低患 CHF 和 AD 的风险。这凸显了艾多沙班改善患者预后的潜力，并强调了其与治疗房颤病例的相关性。

Direct oral anticoagulants (DOACs) outperform warfarin in vascular and bleeding events in atrial fibrillation (AF) patients. Yet, effects of DOACs on congestive heart failure (CHF) and Alzheimer's disease (AD) remain less explored.Using the Taiwan National Health Insurance Research Database, a nationwide retrospective cohort study was conducted. The study matched 5,683 non-valvular atrial fibrillation (NVAF) edoxaban patients with 11,366 warfarin patients, and 703 NVAF with cancer (NVAF-C) edoxaban patients with 1,406 warfarin patients. Vasular and non-vascular outcomes, with focuses on CHF and AD, were compared between the edoxaban and warfarin users.Edoxaban significantly lowered adjusted hazrad ratio (aHR) of all-cause mortality, hospitalization for gastrointestinal bleeding, and CHF (0.37, 0.74, and 0.26, respectively, in NVAF; 0.39, 0.67, and 0.31, respectively, in NVAF-C, all p < 0.05), compared to warfarin. Edoxaban was associated with significantly lower aHRs of acute myocardial infarction, peripheral artery disease, venous thromboembolism, pulmonary embolism, and AD (0.71, 0.48, 0.55, 0.20, and 0.66, respectively; all p < 0.05) in NVAF patients versus warfarin. However, edoxaban had higher aHR of hospitalized bleeding (1.19, p = 0.002) than warfarin in NVAF patients, but not in NVAF-C patients.Edoxaban demonstrated lowered CHF risks in both NVAF and NVAF-C patients, and reduced AD occurrence in NVAF patients versus warfarin. These findings advocate for edoxaban's use in AF cases.What Is New?: The study reveals that in patients with atrial fibrillation (AF), edoxaban, a direct oral anticoagulant (DOAC), demonstrates significant advantages over warfarin. Notably, edoxaban is associated with a reduced risk of congestive heart failure (CHF) and Alzheimer's disease (AD) when compared to warfarin.Clinical Implications?: These findings have important clinical implications. Edoxaban appears to be a superior anticoagulant choice for AF patients, as it lowers the risk of CHF and AD. This highlights the potential of edoxaban to improve patient outcomes and underscores its relevance for managing AF cases.