Non-vitamin K antagonist oral anticoagulants were associated with a reduced risk of stroke, systemic embolism, intracranial hemorrhage, and mortality compared to vitamin K antagonists.
Meta-Analysis
Do non-vitamin K antagonist oral anticoagulants reduce the risk of stroke, bleeding, and mortality compared to vitamin K antagonists in patients with non-valvular atrial fibrillation in real-world settings?
This network meta-analysis of real-world evidence confirms that non-vitamin K antagonist oral anticoagulants are generally safer and more effective than vitamin K antagonists for stroke prevention in non-valvular atrial fibrillation.
Aim: To compare real-world effectiveness/safety of non-vitamin K antagonist oral anticoagulants and vitamin K antagonists among patients with non-valvular atrial fibrillation. Materials & methods: A systematic review of electronic databases yielded 7661 citations published from January 2013 to January 2020. Fifty-five studies were included in Bayesian network meta-analyses of hazard ratios. Results & conclusion: In comparison with vitamin K antagonists, apixaban, dabigatran and rivaroxaban were associated with a reduced risk of stroke or systemic embolism, ischemic stroke, intracranial hemorrhage and all-cause mortality. Apixaban, dabigatran and edoxaban, but not rivaroxaban, were associated with a reduced risk of major bleeding. This study confirmed the effectiveness and safety of non-vitamin K antagonist oral anticoagulants for the treatment of non-valvular atrial fibrillation in real-world settings, consistent with clinical trial evidence.
Deitelzweig et al. (Fri,) conducted a meta-analysis in non-valvular atrial fibrillation. Non-vitamin K antagonist oral anticoagulants vs. Vitamin K antagonists was evaluated on Stroke or systemic embolism, ischemic stroke, intracranial hemorrhage, all-cause mortality, and major bleeding. Non-vitamin K antagonist oral anticoagulants were associated with a reduced risk of stroke, systemic embolism, intracranial hemorrhage, and mortality compared to vitamin K antagonists.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: