dc.creator | Archontakis-Barakakis P., Li W., Kalaitzoglou D., Tzelves L., Manolopoulos A., Giannopoulos S., Giamouzis G., Giannakoulas G., Batsidis A., Palaiodimos L., Ntaios G., Lip G.Y.H., Kokkinidis D.G. | en |
dc.date.accessioned | 2023-01-31T07:32:44Z | |
dc.date.available | 2023-01-31T07:32:44Z | |
dc.date.issued | 2022 | |
dc.identifier | 10.1111/bcp.15464 | |
dc.identifier.issn | 03065251 | |
dc.identifier.uri | http://hdl.handle.net/11615/70752 | |
dc.description.abstract | Aims: Observational studies have investigated the effectiveness and safety of direct oral anticoagulants (DOACs) and vitamin K antagonists (VKAs) used in nonvalvular atrial fibrillation. We performed a systematic review and meta-analysis assessing the risk of ischaemic stroke, thromboembolism (TE) and intracranial haemorrhage (ICH) associated with the use of DOACs and VKAs. Methods: Medline and Embase were systematically searched until April 2021. Observational studies were gathered and hazard ratios (HRs) with 95% confidence intervals (CI) were extracted. Subgroup analyses based on DOAC doses, history of chronic kidney disease, stroke, exposure to VKA, age and sex were performed. A random-effects model was used. Results: We included 92 studies and performed 107 comparisons. Apixaban was associated with lower risk of stroke (HR: 0.82, 95% CI: 0.68–0.99) compared to dabigatran. Rivaroxaban was associated with lower risk of stroke (HR: 0.90, 95% CI: 0.83–0.98) compared to VKA. Dabigatran (HR: 0.85, 95% CI: 0.80–0.91), rivaroxaban (HR: 0.83, 95% CI: 0.77–0.89) and apixaban (HR: 0.75, 95% CI: 0.65–0.86) were associated with lower risk for TE/stroke compared to VKA. Apixaban (HR: 1.32, 95% CI: 1.03–1.68) and rivaroxaban (HR: 1.58, 95% CI: 1.31–1.89) were associated with higher risk of ICH compared to dabigatran. Dabigatran (HR: 0.48, 95% CI: 0.44–0.52), apixaban (HR: 0.60, 95% CI: 0.49–0.73) and rivaroxaban (HR: 0.73, 95% CI: 0.65–0.81) were associated with lower risk of ICH compared to VKA. Conclusion: Our study demonstrated significant differences in the risk of ischaemic stroke, TE/stroke and ICH associated with individual DOACs compared to both other DOACs and VKA. © 2022 British Pharmacological Society. | en |
dc.language.iso | en | en |
dc.source | British Journal of Clinical Pharmacology | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85135785939&doi=10.1111%2fbcp.15464&partnerID=40&md5=618c2e64b4d8a26faf2be5a10cf52498 | |
dc.subject | anticoagulant agent | en |
dc.subject | antivitamin K | en |
dc.subject | apixaban | en |
dc.subject | dabigatran | en |
dc.subject | rivaroxaban | en |
dc.subject | anticoagulant agent | en |
dc.subject | dabigatran | en |
dc.subject | dipyrone | en |
dc.subject | rivaroxaban | en |
dc.subject | vitamin K group | en |
dc.subject | aged | en |
dc.subject | Article | en |
dc.subject | atrial fibrillation | en |
dc.subject | brain hemorrhage | en |
dc.subject | drug efficacy | en |
dc.subject | drug megadose | en |
dc.subject | drug safety | en |
dc.subject | drug use | en |
dc.subject | female | en |
dc.subject | human | en |
dc.subject | ischemic stroke | en |
dc.subject | low drug dose | en |
dc.subject | male | en |
dc.subject | medical history | en |
dc.subject | meta analysis | en |
dc.subject | publication bias | en |
dc.subject | risk assessment | en |
dc.subject | risk factor | en |
dc.subject | stroke patient | en |
dc.subject | systematic review | en |
dc.subject | thromboembolism | en |
dc.subject | brain hemorrhage | en |
dc.subject | brain ischemia | en |
dc.subject | cerebrovascular accident | en |
dc.subject | complication | en |
dc.subject | oral drug administration | en |
dc.subject | thromboembolism | en |
dc.subject | Administration, Oral | en |
dc.subject | Anticoagulants | en |
dc.subject | Atrial Fibrillation | en |
dc.subject | Brain Ischemia | en |
dc.subject | Dabigatran | en |
dc.subject | Humans | en |
dc.subject | Intracranial Hemorrhages | en |
dc.subject | Ischemic Stroke | en |
dc.subject | Pyridones | en |
dc.subject | Rivaroxaban | en |
dc.subject | Stroke | en |
dc.subject | Thromboembolism | en |
dc.subject | Vitamin K | en |
dc.subject | John Wiley and Sons Inc | en |
dc.title | Effectiveness and safety of intracranial events associated with the use of direct oral anticoagulants for atrial fibrillation: A systematic review and meta-analysis of 92 studies | en |
dc.type | journalArticle | en |