The provided text contains only the editorial board information for the journal Thrombosis and Haemostasis and lacks the abstract or full text of the systematic review and meta-analysis.
Systematic Review
Do direct oral anticoagulants (DOACs) improve efficacy and safety outcomes in patients with morbid obesity and AF or VTE compared to vitamin K antagonists (VKAs)?
In patients with morbid obesity, DOACs appear to offer similar efficacy for stroke prevention and better efficacy for VTE recurrence, along with lower major bleeding risk compared to VKAs, though evidence is limited by observational confounding.
OBJECTIVES: Obesity is associated with increased risks of atrial fibrillation (AF) and venous thromboembolism (VTE) for which anticoagulation is commonly used. However, data on the efficacy and safety of oral anticoagulants in patients with morbid obesity are limited. METHODS: We conducted a systematic review and meta-analysis to evaluate the efficacy and safety of direct oral anticoagulants (DOACs) or vitamin K antagonists (VKAs) for AF or VTE in patients with morbid obesity. RESULTS: = 77,687). The primary efficacy outcome was stroke/systemic embolism or recurrent VTE, and the primary safety outcome was major bleeding. DOACs were associated with a pooled incidence rate of stroke/systemic embolism of 1.16 per 100 person-years, compared to 1.18 with VKAs. The incidence of recurrent VTE on DOACs was 3.83 per 100 person-years, compared to 6.81 on VKAs. In both VTE and AF populations, DOACs were associated with lower risks of major bleeding compared to VKAs. However, all observational studies had moderate to serious risks of bias. CONCLUSION: Patients with morbid obesity on DOACs had similar risks of stroke/systemic embolism, lower rates of recurrent VTE, and major bleeding events compared to those on VKAs. However, the certainty of evidence was low given that studies were mostly observational with high risk of confounding.
Wang et al. (Mon,) conducted a systematic review in Morbid obesity requiring oral anticoagulants. Oral Anticoagulants was evaluated. The provided text contains only the editorial board information for the journal Thrombosis and Haemostasis and lacks the abstract or full text of the systematic review and meta-analysis.