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August 8, 2013Cochrane library106 citations

Factor Xa inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in patients with atrial fibrillation

KSKarsten MH Bruins SlotOslo University HospitalEBEivind BergePreventive Cardiology

Key Result

Factor Xa inhibitors significantly reduced strokes and systemic embolic events compared to warfarin in patients with atrial fibrillation.

Structured PICO

Do Factor Xa inhibitors reduce cerebral or systemic embolism compared to vitamin K antagonists in patients with atrial fibrillation?

P
Population
patients with atrial fibrillation
I
Intervention
Factor Xa inhibitors
C
Comparator
vitamin K antagonists (warfarin)
O
Outcome
cerebral or systemic embolism (strokes and systemic embolic events)hard clinical

Factor Xa inhibitors effectively reduce strokes and systemic embolic events compared to warfarin in patients with atrial fibrillation, with a favorable safety profile regarding intracranial hemorrhage.

Limitations

  • Evidence for a reduction of major bleedings is somewhat less robust
  • No conclusive evidence to determine which factor Xa inhibitor is more effective and safer
  • Head-to-head studies of the different factor Xa inhibitors have not yet been performed

Abstract

Factor Xa inhibitors significantly reduced the number of strokes and systemic embolic events compared with warfarin in patients with AF. Factor Xa inhibitors also seem to reduce the number of major bleedings and ICHs compared with warfarin, though the evidence for a reduction of major bleedings is somewhat less robust. There is currently no conclusive evidence to determine which factor Xa inhibitor is more effective and safer for long-term anticoagulant treatment of patients with AF as head-to-head studies of the different factor Xa inhibitors have not yet been performed.

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Cite This Study

Slot et al. (2013) studied this question. Factor Xa inhibitors significantly reduced strokes and systemic embolic events compared to warfarin in patients with atrial fibrillation.

synapsesocial.com/papers/69813150ce4d1f8e18d4e85ehttps://doi.org/10.1002/14651858.cd008980.pub2
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