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Dabigatran,rivaroxaban,and apixaban are superior to warfarin in Asian patients with non-valvular atrial fibrillation:An updated metaanalysis

查看全文 作　　者：Wei-Jia [1]Li;Paraschos Archontakis-[1]Barakakis;Leonidas [1]Palaiodimos;Dimitrios [2]Kalaitzoglou;Lazaros [3]Tzelves;Apostolos [4]Manolopoulos;Yu-Chiang [1]Wang;Stefanos [5]Giannopoulos;Robert [1]Faillace;Damianos G [1]Kokkinidis 高影响力作者 机构地区：[1]Department of Medicine,Jacobi Medical Center,Bronx,NY 10461,United States;[2]Department of Surgery,424 General Army Hospital of Thessaloniki,Thessaloniki 56429,Greece;[3]Department of Urology,Sismanogleio Hospital,Athens 15126,Greece;[4]Clinical Research and Evidence-Based Medicine Unit,Aristotle University of Thessaloniki,Thessaloniki 54124,Greece;[5]Division of Cardiology,Rocky Mountain Regional VA Medical Center,Denver,CO 80045,United States高影响力机构 出　　处：《World Journal of Cardiology》索引2021年第13卷第4期,共13页高影响力期刊 摘　　要：BACKGROUND Most of the randomized clinical trials that led to the wide use of non-vitamin K antagonist oral anticoagulants for stroke prevention in patients with atrial fibrillation(AF)originated from western countries.AIM To systematically review and quantitatively synthesize the real-world data regarding the efficacy and safety of dabigatran,rivaroxaban,and apixaban compared to warfarin for stroke prevention in Asian patients with non-valvular AF.METHODS Medline,Cochrane,and ClinicalTrial.gov databases were reviewed.A randomeffect model meta-analysis was used and I-square was utilized to assess the heterogeneity.The primary outcome was ischemic stroke.The secondary outcomes were all-cause mortality,major bleeding,intracranial hemorrhage,and gastrointestinal bleeding.RESULTS Twelve studies from East Asia or Southeast Asia and 441450 patients were included.Dabigatran,rivaroxaban,and apixaban were associated with a significant reduction in the incidence of ischemic stroke[hazard ratio(HR)=0.78,95%confidence interval(CI):0.65-0.94;HR=0.79,95%CI:0.74-0.85,HR=0.70,95%CI:0.62-0.78;respectively],all-cause mortality(HR=0.68,95%CI:0.56-0.83;HR=0.66,95%CI:0.52-0.84;HR=0.66,95%CI:0.49-0.90;respectively),and major bleeding(HR=0.61,95%CI:0.54-0.69;HR=0.70,95%CI:0.54-0.90;HR=0.58,95%CI:0.43-0.78;respectively)compared to warfarin.CONCLUSION Dabigatran,rivaroxaban,and apixaban appear to be superior to warfarin in both efficacy and safety in Asians with non-valvular AF. 关 键 词：Novel oral anticoagulant Direct oral anticoagulant Atrial fibrillation Asian population DABIGATRAN RIVAROXABAN APIXABAN WARFARIN
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