Effectiveness and safety of direct oral anticoagulants versus vitamin K antagonists in atrial fibrillation patients with liver disease: a systematic review and meta-analysis
Systematic review reveals direct oral anticoagulants reduce major bleeding in atrial fibrillation patients with liver disease, indicating a safer alternative to vitamin K antagonists.
Key Points
DOACs significantly lower major bleeding risk (RR: 0.64) compared to VKAs in atrial fibrillation patients with liver disease.
Intracranial bleeding risk is reduced with DOACs (RR: 0.43) versus VKAs, suggesting a safer option for those with liver conditions.
Fourteen studies involving 44,848 participants were systematically analyzed to compare anticoagulants in this context.
Apixaban offers more favorable safety over rivaroxaban in patients with liver disease, while both show similar efficacy in cirrhotic patients.