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

作　　者：Wei-Jia Li Paraschos Archontakis-Barakakis Leonidas Palaiodimos Dimitrios Kalaitzoglou Lazaros Tzelves Apostolos Manolopoulos Yu-Chiang Wang Stefanos Giannopoulos Robert Faillace Damianos G Kokkinidis 

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

出　　处：《World Journal of Cardiology》2021年第4期82-94,共13页世界心脏病学杂志（英文版）（电子版）

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 

分 类 号：R541.75[医药卫生—心血管疾病]