The safety of NOACs in atrial fibrillation patient subgroups:A narrative review

Autor: Gregory Y.H. Lip
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Stroke/etiology
medicine.medical_specialty
Pyridines
Pyridones
Rivaroxaban/administration & dosage
Patient subgroups
MEDLINE
Administration
Oral
Hemorrhage
030204 cardiovascular system & hematology
Warfarin/adverse effects
03 medical and health sciences
0302 clinical medicine
Rivaroxaban
Risk Factors
Thiazoles/administration & dosage
Hemorrhage/chemically induced
Atrial Fibrillation
medicine
Humans
Dabigatran/administration & dosage
cardiovascular diseases
030212 general & internal medicine
Pyridines/administration & dosage
Intensive care medicine
Stroke
Anticoagulants/administration & dosage
Pyridones/administration & dosage
business.industry
Warfarin
Age Factors
Anticoagulants
Atrial fibrillation
General Medicine
medicine.disease
Pyrazoles/administration & dosage
Dabigatran
Clinical trial
Thiazoles
Clinical Trials
Phase III as Topic
Pyrazoles
Narrative review
business
Atrial Fibrillation/complications
Major bleeding
medicine.drug
Zdroj: Lip, G Y H 2019, ' The safety of NOACs in atrial fibrillation patient subgroups : A narrative review ', International Journal of Clinical Practice, vol. 73, no. 2, e13285 . https://doi.org/10.1111/ijcp.13285
INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
DOI: 10.1111/ijcp.13285
Popis: AIM: Four non-vitamin K oral anticoagulants (NOACs) have been evaluated in clinical trials for the prevention of stroke in patients with atrial fibrillation (AF). Although each of the NOACs have been shown to be at least non-inferior to warfarin for efficacy and safety outcomes, controversy remains over the relative safety of each NOAC in patient subgroups. This narrative review provides an overview of phase III data on NOAC trials for the prevention of stroke in AF, with a focus on reporting the safety of each agent in key patient subgroups based on age, gender, accumulated risk factors, and primary or secondary prevention of stroke.METHODS: A comprehensive literature search was completed and, where data permit, analyses of phase III trials of the NOACs are presented for each patient subgroup.RESULTS: Analyses of key safety outcomes from NOAC trials were completed using primary trial data, including major bleeding and all-cause mortality. The safety of NOACs was generally consistent and favourable compared to warfarin according to patient age, gender, previous history of stroke, and the presence of risk factors for stroke.CONCLUSIONS: The safety of the NOACs compared to warfarin was generally favourable across different patient subgroups, including those perceived to be at 'high risk' for adverse outcomes. However, certain NOACs may be preferable to warfarin in some subgroups, based on indirect analyses. This article is protected by copyright. All rights reserved.
Databáze: OpenAIRE
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