Non-vitamin K antagonist oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation: a systematic review and meta-analysis

source extracted confidence: high 2026-04-09
#administration-oral #aged #atrial-fibrillation #cardiomyopathy-hypertrophic #factor-xa-inhibitors

Non-vitamin K antagonist oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation: a systematic review and meta-analysis

Zhou et al., 2020 | J Thromb Thrombolysis | Meta Analysis

Citation

Zhou Yunguo, He Wenfeng, ... Zhu Wengen. Non-vitamin K antagonist oral anticoagulants in patients with hypertrophic cardiomyopathy and atrial fibrillation: a systematic review and meta-analysis. J Thromb Thrombolysis. 2020-Aug;50(2):311-317. doi:10.1007/s11239-019-02008-3

Abstract

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.

Key Findings

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.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population hypertrophic cardiomyopathy
Sample Size See abstract
Age Range See abstract
Condition See abstract

MeSH Terms

  • Administration, Oral
  • Aged
  • Atrial Fibrillation
  • Cardiomyopathy, Hypertrophic
  • Factor Xa Inhibitors
  • Female
  • Hemorrhage
  • Humans
  • Male
  • Middle Aged
  • Observational Studies as Topic
  • Risk Assessment
  • Risk Factors
  • Stroke
  • Thromboembolism
  • Time Factors
  • Treatment Outcome

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: vitamin-k

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09