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Real-world oral anticoagulants for Asian patients with non-valvular atrial fibrillation: A PRISMA-compliant article

BACKGROUND AND PURPOSE: This study aimed to evaluate the comparative efficacy and safety of 4 non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in Asians with non-valvular atrial fibrillation in real-world practice through a network meta-analysis of observational studies. METHODS: We...

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Autores principales: Kim, Seung Min, Jeon, Eun-Tae, Jung, Jin-Man, Lee, Ji-Sung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8360482/
https://www.ncbi.nlm.nih.gov/pubmed/34397907
http://dx.doi.org/10.1097/MD.0000000000026883
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author Kim, Seung Min
Jeon, Eun-Tae
Jung, Jin-Man
Lee, Ji-Sung
author_facet Kim, Seung Min
Jeon, Eun-Tae
Jung, Jin-Man
Lee, Ji-Sung
author_sort Kim, Seung Min
collection PubMed
description BACKGROUND AND PURPOSE: This study aimed to evaluate the comparative efficacy and safety of 4 non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in Asians with non-valvular atrial fibrillation in real-world practice through a network meta-analysis of observational studies. METHODS: We searched multiple comprehensive databases (PubMed, Embase, and Cochrane library) for studies published until August 2020. Hazard ratios and 95% confidence intervals were used for the pooled estimates. Efficacy outcomes included ischemic stroke (IS), stroke/systemic embolism (SSE), myocardial infarction (MI), and all-cause mortality, and safety outcomes included major bleeding, gastrointestinal (GI) bleeding, and intracerebral hemorrhage (ICH). The P score was calculated for ranking probabilities. Subgroup analyses were separately performed in accordance with the dosage range of NOACs (“standard-” and “low-dose”). RESULTS: A total of 11, 6, and 8 studies were allocated to the total population, standard-dose group, and low-dose group, respectively. In the total study population, edoxaban ranked the best in terms of IS and ICH prevention and apixaban ranked the best for SSE, major bleeding, and GI bleeding. In the standard-dose regimen, apixaban ranked the best in terms of IS and SSE prevention. For major bleeding, GI bleeding, and ICH, edoxaban ranked the best. In the low-dose regimen, edoxaban ranked the best for IS, SSE, GI bleeding, and ICH prevention. For major bleeding prevention, apixaban ranked best. CONCLUSIONS: All 4 NOACs had different efficacy and safety outcomes according to their type and dosage. Apixaban and edoxaban might be relatively better and more well-balanced treatment for Asian patients with non-valvular atrial fibrillation.
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spelling pubmed-83604822021-08-17 Real-world oral anticoagulants for Asian patients with non-valvular atrial fibrillation: A PRISMA-compliant article Kim, Seung Min Jeon, Eun-Tae Jung, Jin-Man Lee, Ji-Sung Medicine (Baltimore) 5300 BACKGROUND AND PURPOSE: This study aimed to evaluate the comparative efficacy and safety of 4 non-vitamin K antagonist oral anticoagulants (NOACs) and warfarin in Asians with non-valvular atrial fibrillation in real-world practice through a network meta-analysis of observational studies. METHODS: We searched multiple comprehensive databases (PubMed, Embase, and Cochrane library) for studies published until August 2020. Hazard ratios and 95% confidence intervals were used for the pooled estimates. Efficacy outcomes included ischemic stroke (IS), stroke/systemic embolism (SSE), myocardial infarction (MI), and all-cause mortality, and safety outcomes included major bleeding, gastrointestinal (GI) bleeding, and intracerebral hemorrhage (ICH). The P score was calculated for ranking probabilities. Subgroup analyses were separately performed in accordance with the dosage range of NOACs (“standard-” and “low-dose”). RESULTS: A total of 11, 6, and 8 studies were allocated to the total population, standard-dose group, and low-dose group, respectively. In the total study population, edoxaban ranked the best in terms of IS and ICH prevention and apixaban ranked the best for SSE, major bleeding, and GI bleeding. In the standard-dose regimen, apixaban ranked the best in terms of IS and SSE prevention. For major bleeding, GI bleeding, and ICH, edoxaban ranked the best. In the low-dose regimen, edoxaban ranked the best for IS, SSE, GI bleeding, and ICH prevention. For major bleeding prevention, apixaban ranked best. CONCLUSIONS: All 4 NOACs had different efficacy and safety outcomes according to their type and dosage. Apixaban and edoxaban might be relatively better and more well-balanced treatment for Asian patients with non-valvular atrial fibrillation. Lippincott Williams & Wilkins 2021-08-13 /pmc/articles/PMC8360482/ /pubmed/34397907 http://dx.doi.org/10.1097/MD.0000000000026883 Text en Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/)
spellingShingle 5300
Kim, Seung Min
Jeon, Eun-Tae
Jung, Jin-Man
Lee, Ji-Sung
Real-world oral anticoagulants for Asian patients with non-valvular atrial fibrillation: A PRISMA-compliant article
title Real-world oral anticoagulants for Asian patients with non-valvular atrial fibrillation: A PRISMA-compliant article
title_full Real-world oral anticoagulants for Asian patients with non-valvular atrial fibrillation: A PRISMA-compliant article
title_fullStr Real-world oral anticoagulants for Asian patients with non-valvular atrial fibrillation: A PRISMA-compliant article
title_full_unstemmed Real-world oral anticoagulants for Asian patients with non-valvular atrial fibrillation: A PRISMA-compliant article
title_short Real-world oral anticoagulants for Asian patients with non-valvular atrial fibrillation: A PRISMA-compliant article
title_sort real-world oral anticoagulants for asian patients with non-valvular atrial fibrillation: a prisma-compliant article
topic 5300
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8360482/
https://www.ncbi.nlm.nih.gov/pubmed/34397907
http://dx.doi.org/10.1097/MD.0000000000026883
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