TitleComparison of non-vitamin K antagonist oral anticoagulants on bleeding and thrombosis
AuthorsLiu, Zhiyan
Ma, Lingyue
Zhang, Hanxu
Mu, Guangyan
Xie, Qiufen
Zhou, Shuang
Wang, Zining
Wang, Zhe
Hu, Kun
Gong, Yanjun
Jiang, Jie
Xiang, Qian
Cui, Yimin
AffiliationPeking Univ First Hosp, Dept Pharm, 6,Dahongluochang St, Beijing 100034, Peoples R China
Peking Univ, Hlth Sci Ctr, Sch Pharmaceut Sci, Beijing, Peoples R China
Peking Univ First Hosp, Dept Cardiol, Beijing, Peoples R China
KeywordsATRIAL-FIBRILLATION
REAL-WORLD
STROKE PREVENTION
MORTALITY RISKS
DABIGATRAN
RIVAROXABAN
WARFARIN
SAFETY
APIXABAN
METAANALYSIS
Issue DateAug-2021
PublisherJOURNAL OF CLINICAL PHARMACY AND THERAPEUTICS
AbstractWhat is known and objective Limited data are available for the comparison between different non-vitamin K antagonist oral anticoagulants (NOACs) on clinical outcomes. We aimed to provide evidence of different NOACs for patients with non-valvular atrial fibrillation (NVAF). Methods Electronic databases were searched from inception through 22 March 2020 to identify eligible studies in which clinical outcomes (stroke, systemic embolism [SE], bleeding or death events) were directly compared between different NOACs. Results 29 real-world studies enrolled more than 700,000 patients were included. Compared with dabigatran, apixaban had higher risk of death (OR 1.07), major bleeding (1.43), GI bleeding (1.64), ischaemic stroke and stroke/SE events (1.10); rivaroxaban had higher risk of death (1.28), major bleeding (1.24), GI bleeding (1.14) and ischaemic stroke (1.08). Compared with rivaroxaban, apixaban had lower risk of death (0.8), major bleeding (0.56) and ischaemic stroke events (0.71). Compared with edoxaban, rivaroxaban had higher risk of major bleeding (2.83), GI bleeding (5.18) and ischaemic stroke (2.28). What is new and conclusion In view of the global burden of disease and the routine use of NOACs worldwide, the findings have immediate and important implications. Our data suggested that apixaban might be the priority choice in prevention of bleeding and stroke and dabigatran could be the priority choice in prevention of death events. Trial registration This systematic review and meta-analysis were conducted and reported according to the Preferred Reporting Items for Systematic Reviews (PRISMA), Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines and was registered with PROSPERO (CRD42019140553).
URIhttp://hdl.handle.net/20.500.11897/624156
ISSN0269-4727
DOI10.1111/jcpt.13514
IndexedSCI(E)
Appears in Collections:第一医院

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