Key result
New-generation oral anticoagulants provided no net clinical benefit over placebo in patients receiving antiplatelet therapy after ACS (OR 0.98; 95% CI 0.90-1.06; P=.57) due to increased major bleeding.
Why the study?
Does the addition of new-generation oral anticoagulant agents to antiplatelet therapy improve net clinical benefit in patients after an acute coronary syndrome?
Population
31,286 patients receiving antiplatelet therapy after an acute coronary syndrome pooled from 7 prospective…
Comparison
New-generation oral anticoagulant agents added… vs Placebo added to antiplatelet therapy
Design
Meta-analysis, placebo-controlled
Authors
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No net benefit from adding new-generation OACs to antiplatelet therapy post-ACS; confirms bleeding offsets ischemic gains in meta-analysis.
Meta-Analysis (n=31,286)
Does the addition of new-generation oral anticoagulant agents to antiplatelet therapy improve net clinical benefit in patients after an acute coronary syndrome?
Odds Ratio: 0.98 (95% CI 0.9–1.06)
p-value: p=.57
The addition of new-generation oral anticoagulants to antiplatelet therapy after an acute coronary syndrome provides no net clinical benefit, as moderate ischemic benefits are offset by a dramatic increase in major bleeding.
Komócsi et al. (2012) conducted a meta-analysis in Acute coronary syndrome (n=31,286). New-generation oral anticoagulant agents (anti-Xa or direct thrombin inhibitors) vs. Placebo was evaluated on Net clinical benefit (sum of composite ischemic events and major bleeding events) (OR 0.98, 95% CI 0.90-1.06, p=.57). New-generation oral anticoagulants provided no net clinical benefit over placebo in patients receiving antiplatelet therapy after ACS (OR 0.98; 95% CI 0.90-1.06; P=.57) due to increased major bleeding.
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