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2021-11-12

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cc-by (c) Bonanad, Clara et al., 2021
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/183879

Direct Oral Anticoagulants versus Warfarin in Octogenarians with Nonvalvular Atrial Fibrillation: A Systematic Review and Meta-Analysis

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Recurs relacionat

https://doi.org/10.3390/jcm10225268

Resum

Direct oral anticoagulants (DOACs) have been demonstrated to be more effective and safer than vitamin-K antagonist (VKA) for stroke prevention in patients with nonvalvular atrial fibrillation (AF). This meta-analysis aims to assess the effect of DOACS vs. VKA in patients ≥ 80 and AF. Primary endpoints were stroke or systemic embolism and all-cause death. Secondary endpoints included major bleeding, intracranial bleeding, and gastrointestinal bleeding. A random-effects model was selected due to significant heterogeneity. A total of 147,067 patients from 16 studies were included, 71,913 (48.90%) treated with DOACs and 75,154 with VKA (51.10%). The stroke rate was significantly lower in DOACs group compared with warfarin group (Relative risk (RR): 0.72; 95% confidence interval (CI): 0.63-0.82; p < 0.001). All-cause mortality was significantly lower in DOACs group compared with warfarin group (RR: 0.82; 95% CI: 0.70-0.96; p = 0.012). Compared to warfarin, DOACs were not associated with reductions in major bleeding (RR: 0.85, 95% CI 0.69-1.04; p = 0.108) or gastrointestinal bleeding risk (RR: 1.08, 95% CI 0.76-1.53; p = 0.678) but a 43% reduction of intracranial bleeding (RR: 0.47, IC 95% 0.36-0.60; p < 0.001) was observed. Our meta-analysis demonstrates that DOACs are effective and safe with statistical superiority when compared with warfarin in octogenarians with AF.

Matèries

Persones grans, Malalties coronàries, Anticoagulants (Medicina), Infart de miocardi

Matèries (anglès)

Older people, Coronary diseases, Anticoagulants (Medicine), Myocardial infarction

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Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

BONANAD, Clara, GARCÍA BLAS, Sergio, TORRES LLERGO, Javier, FERNÁNDEZ OLMO, Rosa, DÍEZ VILLANUEVA, Pablo, ARIZA SOLÉ, Albert, MARTÍNEZ SELLÉS, Manuel, RAPOSEIRAS ROUBÍN, Sergio, AYESTA, Ana, BERTOMEU GONZÁLEZ, Vicente, TARAZONA SANTABALBINA, Francisco, FACILA, Lorenzo, VIVAS, David, GABALDÓN PÉREZ, Ana, BODI, Vicente, NUÑEZ, Julio, CORDERO, Alberto. Direct Oral Anticoagulants versus Warfarin in Octogenarians with Nonvalvular Atrial Fibrillation: A Systematic Review and Meta-Analysis. _Journal of Clinical Medicine_. 2021. Vol. 10, núm. 22, pàgs. 5268. [consulta: 20 de gener de 2026]. ISSN: 2077-0383. [Disponible a: https://hdl.handle.net/2445/183879]

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