Dabigatran, Rivaroxaban, or Apixaban versus Warfarin in Patients with Nonvalvular Atrial Fibrillation : A Systematic Review and Meta-Analysis of Subgroups
Joint Authors
Calvo-Rojas, Gonzalo
Vargas-Castrillón, Emilio
Suárez-Gea, M. Luisa
Terleira-Fernández, Ana Isabel
Gómez-Outes, Antonio
Source
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-18, 18 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-12-22
Country of Publication
Egypt
No. of Pages
18
Main Subjects
Abstract EN
Background.
New oral anticoagulants (NOAC; rivaroxaban, dabigatran, apixaban) have become available as an alternative to warfarin anticoagulation in non-valvular atrial fibrillation (NVAF).
Methods.
MEDLINE and CENTRAL, regulatory agencies websites, clinical trials registers and conference proceedings were searched to identify randomised controlled trials of NOAC versus warfarin in NVAF.
Two investigators reviewed all studies and extracted data on patient and study characteristics along with cardiovascular outcomes.
Relative risks (RR) and 95% confidence intervals (CI) were estimated using a random effect meta-analysis.
Results.
Three clinical trials in 50,578 patients were included.
The risk of non-hemorrhagic stroke and systemic embolic events (SEE) was similar with the NOAC and warfarin (RR=0.93; 95% CI=0.83–1.04), while the risk of intracranial bleeding (ICB) with the NOAC was lower than with warfarin (RR = 0.46; 95% CI = 0.33–0.65).
We found differences in the effect size on all strokes and SEE depending on geographic region as well as on non-hemorrhagic stroke, SEE, bleeding and mortality depending on time in therapeutic range.
Conclusion.
The NOAC seem no more effective than warfarin for prevention of nonhemorrhagic stroke and SEE in the overall NVAF population, but are generally associated with a lower risk of ICB than warfarin.
American Psychological Association (APA)
Gómez-Outes, Antonio& Terleira-Fernández, Ana Isabel& Calvo-Rojas, Gonzalo& Suárez-Gea, M. Luisa& Vargas-Castrillón, Emilio. 2013. Dabigatran, Rivaroxaban, or Apixaban versus Warfarin in Patients with Nonvalvular Atrial Fibrillation : A Systematic Review and Meta-Analysis of Subgroups. Thrombosis،Vol. 2013, no. 2013, pp.1-18.
https://search.emarefa.net/detail/BIM-487444
Modern Language Association (MLA)
Gómez-Outes, Antonio…[et al.]. Dabigatran, Rivaroxaban, or Apixaban versus Warfarin in Patients with Nonvalvular Atrial Fibrillation : A Systematic Review and Meta-Analysis of Subgroups. Thrombosis No. 2013 (2013), pp.1-18.
https://search.emarefa.net/detail/BIM-487444
American Medical Association (AMA)
Gómez-Outes, Antonio& Terleira-Fernández, Ana Isabel& Calvo-Rojas, Gonzalo& Suárez-Gea, M. Luisa& Vargas-Castrillón, Emilio. Dabigatran, Rivaroxaban, or Apixaban versus Warfarin in Patients with Nonvalvular Atrial Fibrillation : A Systematic Review and Meta-Analysis of Subgroups. Thrombosis. 2013. Vol. 2013, no. 2013, pp.1-18.
https://search.emarefa.net/detail/BIM-487444
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-487444