The role of non-vitamin K antagonist oral anticoagulants in Asian patients with atrial fibrillation: A PRISMA-compliant article

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#administration-oral #aged #anticoagulants #antithrombins #asia

The role of non-vitamin K antagonist oral anticoagulants in Asian patients with atrial fibrillation: A PRISMA-compliant article

Liu et al., 2020 | Medicine (Baltimore) | Systematic Review

Citation

Liu Xuyang, Huang Manxiang, ... Ma Jianyong. The role of non-vitamin K antagonist oral anticoagulants in Asian patients with atrial fibrillation: A PRISMA-compliant article. Medicine (Baltimore). 2020-Jul-02;99(27):e21025. doi:10.1097/MD.0000000000021025

Abstract

BACKGROUND: Given the huge burden of atrial fibrillation (AF) and AF-related stroke in Asia, stroke prevention represents an urgent issue in this region. We herein performed a network meta-analysis to examine the role of non-vitamin K antagonist oral anticoagulants (NOACs) in Asian patients with AF. METHODS: A systematic search of the publications was conducted in PubMed and Embase databases for eligible studies until July 2019. The odds ratios (ORs) and 95% confidence intervals (CIs) were regarded as the effect estimates. The surface under the cumulative ranking area (SUCRA) for the ranking probabilities was calculated. RESULTS: A total of 17 studies were included. For comparisons of NOACs vs warfarin, dabigatran (OR = 0.77, 95% CI 0.68-0.86), rivaroxaban (OR = 0.72, 95% CI 0.65-0.81), apixaban (OR = 0.56, 95% CI 0.49-0.65), but not edoxaban reduced the risk of stroke or systemic embolism, wheres dabigatran (OR = 0.56, 95% CI 0.41-0.76), rivaroxaban (OR = 0.66, 95% CI 0.50-0.86), apixaban (OR = 0.49, 95% CI 0.36-0.66), and edoxaban (OR = 0.34, 95% CI 0.24-0.49) decreased the risk of major bleeding. In reducing the risk of stroke or systemic embolism, apixaban and rivaroxaban ranked the best and second best (SUCRA 0.2% and 31.4%, respectively), followed by dabigatran (50.2%), edoxaban (75.2%), and warfarin (93.0%). In reducing the risk of major bleeding, edoxaban, and apixaban ranked the best and second best (1.5% and 30.8%, respectively), followed by dabigatran (48.4%), rivaroxaban (69.2%), and warfarin (100%). CONCLUSION: NOACs were at least as effective as warfarin, but more safer in Asians with AF. Apixaban was superior to other NOACs for reducing stroke or systemic embolism, while edoxaban showed a better safety profile than other NOACs.

Key Findings

A total of 17 studies were included. For comparisons of NOACs vs warfarin, dabigatran (OR = 0.77, 95% CI 0.68-0.86), rivaroxaban (OR = 0.72, 95% CI 0.65-0.81), apixaban (OR = 0.56, 95% CI 0.49-0.65), but not edoxaban reduced the risk of stroke or systemic embolism, wheres dabigatran (OR = 0.56, 95% CI 0.41-0.76), rivaroxaban (OR = 0.66, 95% CI 0.50-0.86), apixaban (OR = 0.49, 95% CI 0.36-0.66), and edoxaban (OR = 0.34, 95% CI 0.24-0.49) decreased the risk of major bleeding. In reducing the risk

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population af
Sample Size 17
Age Range See abstract
Condition See abstract

MeSH Terms

  • Administration, Oral
  • Aged
  • Anticoagulants
  • Antithrombins
  • Asia
  • Asian People
  • Atrial Fibrillation
  • Cost of Illness
  • Dabigatran
  • Embolism
  • Factor Xa Inhibitors
  • Female
  • Hemorrhage
  • Humans
  • Male
  • Pyrazoles
  • Pyridines
  • Pyridones
  • Rivaroxaban
  • Safety
  • Stroke
  • Thiazoles
  • Warfarin

Evidence Classification

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

Provenance

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