Do DOACs really work better for women?

Study points to the sex difference in thrombotic and haemorrhagic risk

Women with atrial fibrillation appear to have better outcomes from using direct oral anticoagulants (DOACs) than men, according to a study comparing the efficacy and safety outcomes of DOACs versus warfarin.
 
Propensity-score matching was used to compare outcomes in 4972 men and 4834 women diagnosed with AF, who were prescribed oral anticoagulants between 2010 and 2015.
 
The risk of systemic embolism with DOACs versus warfarin was comparable among men and women. However, in women, DOACs were associated with significantly lower risks of intracranial haemorrhage and all-cause mortality.
 
The lower risk of intracranial haemorrhage was consistent in this cohort when compared with warfarin users with both good and poor INR control.
 
Meanwhile, in men, there were no significant differences in safety outcomes between the treatment groups.
 
In addition, in both men and women, the researchers