Key result
High-dose NOACs reduced stroke or systemic embolism by 19% compared to warfarin, but Asian patients with atrial fibrillation and prior stroke have a higher risk of intracranial hemorrhage, suggesting a potential need for reduced doses.
Why the study?
What is the optimal dose of NOACs for Asian patients with atrial fibrillation and prior stroke?
Population
Asian patients with atrial fibrillation and prior stroke or transient ischemic attack
Design
Review
Authors
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Should not yet change NOAC dosing in Asian patients with prior stroke; leaves open optimal regimens for dedicated trials.
What is the optimal dose of NOACs for Asian patients with atrial fibrillation and prior stroke?
Effect estimate: HR 0.81 (95% CI 0.73-0.91)
p-value: p=<0.001
This review highlights the need for further research and clinical trials to determine the optimal, potentially reduced, dose of NOACs for Asian patients with atrial fibrillation and prior stroke.
Bang et al. (2016) conducted a review in Atrial fibrillation and prior stroke or transient ischemic attack. Non-vitamin K oral anticoagulants (NOACs) vs. Warfarin was evaluated on Stroke or systemic embolism (HR 0.81, 95% CI 0.73-0.91, p=<0.001). High-dose NOACs reduced stroke or systemic embolism by 19% compared to warfarin, but Asian patients with atrial fibrillation and prior stroke have a higher risk of intracranial hemorrhage, suggesting a potential need for reduced doses.
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