Abstract | PURPOSE: METHODS: Eligible randomized controlled trials evaluating NOACs for stroke prevention in AF patients were identified from a systematic search of MEDLINE, EMBASE and the Cochrane database. Risk ratios (RRs) and 95 % confidence intervals (CIs) were calculated using a Mantel-Haenzel random-effects model. RESULTS: A total of 13 studies (n = 61,406) were included. Oral direct factor Xa inhibitors were more effective in reducing stroke and systemic embolism compared to controls (RR 0.71, 95 % CI 0.54-0.92, P = 0.009) or vitamin K antagonists (VKAs) (RR 0.84, 95 % CI 0.74-0.94, P = 0.002), with no significant difference in major and clinically relevant non-major (CRNM) bleeding (against controls: RR 0.94, 95 % CI 0.75-1.18, P = 0.60; against VKAs: RR 0.90, 95 % 0.69-1.17, P = 0.44). Oral direct thrombin inhibitors were associated with an improved major and CRNM bleeding profile (both comparisons: RR 0.88, 95 % CI 0.78-0.98, P = 0.02) and a significant reduction in stroke and systemic embolism (against controls: RR 0.79, 95 % CI 0.66-0.93, P = 0.006; against VKAs: RR 0.78, 95 % CI 0.66-0.93, P = 0.006). CONCLUSIONS:
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Authors | Joey S W Kwong, Yat-Yin Lam, Bryan P Yan, Cheuk-Man Yu |
Journal | Cardiovascular drugs and therapy
(Cardiovasc Drugs Ther)
Vol. 27
Issue 1
Pg. 23-35
(Feb 2013)
ISSN: 1573-7241 [Electronic] United States |
PMID | 23224686
(Publication Type: Journal Article, Meta-Analysis)
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Chemical References |
- Anticoagulants
- Factor Xa Inhibitors
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Topics |
- Anticoagulants
(administration & dosage, adverse effects, therapeutic use)
- Atrial Fibrillation
(blood, complications, drug therapy)
- Data Interpretation, Statistical
- Factor Xa Inhibitors
- Hemorrhage
(blood, chemically induced)
- Humans
- Randomized Controlled Trials as Topic
- Stroke
(blood, etiology, prevention & control)
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