Comparison of the Direct Oral Anticoagulants and Warfarin in Patients With Atrial Fibrillation and Valvular Heart Disease: Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials
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Why the study?
DOACs are approved for non-valvular AF, but updated evidence was needed to evaluate their efficacy and safety compared to warfarin in patients with AF and valvular heart disease.
Do direct oral anticoagulants reduce stroke and systemic embolism compared to warfarin in patients with atrial fibrillation and valvular heart disease?
Population
14.902 patients with AF and VHD across 8 RCTs
Comparison
DOACs vs warfarin
Design
Systematic review and meta-analysis of RCTs
Authors
Discussion
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Implication
DOACs reduce stroke/SE and ICH versus warfarin in AF with VHD; extends RCT evidence supporting use across broader VHD populations.
Structured PICO
Do direct oral anticoagulants reduce stroke and systemic embolism compared to warfarin in patients with atrial fibrillation and valvular heart disease?
P
Population
14,902 patients from 8 RCTs with atrial fibrillation and valvular heart disease (including biological and mechanical heart valves)
I
Intervention
Direct oral anticoagulants (DOACs)
C
Comparator
Warfarin
O
Outcome
Stroke and systemic embolism (SE)composite
DOACs are an effective and safe alternative to warfarin for stroke prevention in patients with atrial fibrillation and valvular heart disease.
Cite This Study
Bitar et al. (2021) studied this question.
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