Non-vitamin K antagonist oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation: a systematic review and meta-analysis
| Autor: | Wenfeng He, Yunguo Zhou, Yue Zhou, Wengen Zhu |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Gastrointestinal bleeding Time Factors medicine.drug_class Population Administration Oral Hemorrhage 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Thromboembolism Atrial Fibrillation medicine Humans 030212 general & internal medicine education Stroke Aged education.field_of_study business.industry Warfarin Atrial fibrillation Hematology Vitamin K antagonist Cardiomyopathy Hypertrophic Middle Aged medicine.disease Observational Studies as Topic Treatment Outcome Relative risk Meta-analysis Cardiology Female Cardiology and Cardiovascular Medicine business medicine.drug Factor Xa Inhibitors |
| Zdroj: | Journal of thrombosis and thrombolysis. 50(2) |
| ISSN: | 1573-742X |
| Popis: | Several studies have explored the use of NOACs compared with vitamin K antagonists (VKAs) in patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF); and therefore, we aimed to compare the efficacy and safety outcomes of NOACs with VKAs in this population. We systematically searched the PubMed and Embase databases until August 5, 2019 for studies that compared the effect of NOACs with VKAs in patients with HCM and AF. The risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using a random-effects model. A total of four observational studies were included in this meta-analysis. Overall, compared with VKAs use, the use of NOACs was associated with reduced risks of ischemic stroke (RR 0.49, 95% CI 0.34-0.69), all-cause death (RR 0.44, 95% CI 0.35-0.55), and intracranial hemorrhage (RR 0.43, 95% CI 0.24-0.77). There were no differences in the risks of stroke or systemic embolism, major or clinically relevant bleeding, and gastrointestinal bleeding in patients with NOACs versus VKAs. Re-analyses with a fixed-effects model produced the similar results as the main analyses. For the efficacy and safety outcomes, comparisons of NOACs versus warfarin produced the similar results as those of NOACs versus VKAs. Based on current data from observational studies, compared with VKAs, NOACs had similar or lower risks of thromboembolic and bleeding events in patients with HCM and AF. |
| Databáze: | OpenAIRE |
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