Efficacy and safety of novel oral anticoagulants in patients with atrial nonvalvular atrial fibrillation and diabetes mellitus: a systematic review and meta-analysis
Abstract Objective This study incorporates the results of subgroup analyses of currently published randomized controlled trials (RCTs) and real-world cohort studies to compare the effectiveness and safety of new direct oral anticoagulants (NOACs) and warfarin among nonvalvular atrial fibrillation pa...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | Journal of Translational Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12967-022-03652-9 |
| _version_ | 1818026125591314432 |
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| author | Xuedong Jia Zhao Yin Wan Zhang Shuzhang Du Jian Kang |
| author_facet | Xuedong Jia Zhao Yin Wan Zhang Shuzhang Du Jian Kang |
| author_sort | Xuedong Jia |
| collection | DOAJ |
| description | Abstract Objective This study incorporates the results of subgroup analyses of currently published randomized controlled trials (RCTs) and real-world cohort studies to compare the effectiveness and safety of new direct oral anticoagulants (NOACs) and warfarin among nonvalvular atrial fibrillation patients with diabetes. Methods The PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov databases were searched. Five retrospective cohort studies and four subgroup analyses of RCTs were included in this meta-analysis. Results A meta-analysis of the data of 26,7272 patients showed that for patients with nonvalvular atrial fibrillation and diabetes, NOACs can significantly reduce the incidence of stroke/systemic embolism (SSE), ischaemic stroke, and haemorrhagic stroke compared with warfarin, with no significant difference in major bleeding and all-cause mortality. Additionally, NOACs were superior to warfarin in the incidence of intracranial bleeding, gastrointestinal bleeding, myocardial infarction, and vascular death. Conclusions Among nonvalvular atrial fibrillation patients with diabetes, NOACs were associated with a lower risk of SSE versus warfarin, with no significant difference in major bleeding. Therefore, NOACs may be a better clinical choice. |
| first_indexed | 2024-12-10T04:27:02Z |
| format | Article |
| id | doaj.art-17514511229945d99a5c571649e08943 |
| institution | Directory Open Access Journal |
| issn | 1479-5876 |
| language | English |
| last_indexed | 2024-12-10T04:27:02Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Translational Medicine |
| spelling | doaj.art-17514511229945d99a5c571649e089432022-12-22T02:02:15ZengBMCJournal of Translational Medicine1479-58762022-09-0120111210.1186/s12967-022-03652-9Efficacy and safety of novel oral anticoagulants in patients with atrial nonvalvular atrial fibrillation and diabetes mellitus: a systematic review and meta-analysisXuedong Jia0Zhao Yin1Wan Zhang2Shuzhang Du3Jian Kang4Department of Pharmacy, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Pharmacy, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Pharmacy, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Pharmacy, The First Affiliated Hospital of Zhengzhou UniversityDepartment of Pharmacy, The First Affiliated Hospital of Zhengzhou UniversityAbstract Objective This study incorporates the results of subgroup analyses of currently published randomized controlled trials (RCTs) and real-world cohort studies to compare the effectiveness and safety of new direct oral anticoagulants (NOACs) and warfarin among nonvalvular atrial fibrillation patients with diabetes. Methods The PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov databases were searched. Five retrospective cohort studies and four subgroup analyses of RCTs were included in this meta-analysis. Results A meta-analysis of the data of 26,7272 patients showed that for patients with nonvalvular atrial fibrillation and diabetes, NOACs can significantly reduce the incidence of stroke/systemic embolism (SSE), ischaemic stroke, and haemorrhagic stroke compared with warfarin, with no significant difference in major bleeding and all-cause mortality. Additionally, NOACs were superior to warfarin in the incidence of intracranial bleeding, gastrointestinal bleeding, myocardial infarction, and vascular death. Conclusions Among nonvalvular atrial fibrillation patients with diabetes, NOACs were associated with a lower risk of SSE versus warfarin, with no significant difference in major bleeding. Therefore, NOACs may be a better clinical choice.https://doi.org/10.1186/s12967-022-03652-9New direct oral anticoagulants (NOACs)WarfarinAtrial fibrillationDiabetesEfficacySafety |
| spellingShingle | Xuedong Jia Zhao Yin Wan Zhang Shuzhang Du Jian Kang Efficacy and safety of novel oral anticoagulants in patients with atrial nonvalvular atrial fibrillation and diabetes mellitus: a systematic review and meta-analysis Journal of Translational Medicine New direct oral anticoagulants (NOACs) Warfarin Atrial fibrillation Diabetes Efficacy Safety |
| title | Efficacy and safety of novel oral anticoagulants in patients with atrial nonvalvular atrial fibrillation and diabetes mellitus: a systematic review and meta-analysis |
| title_full | Efficacy and safety of novel oral anticoagulants in patients with atrial nonvalvular atrial fibrillation and diabetes mellitus: a systematic review and meta-analysis |
| title_fullStr | Efficacy and safety of novel oral anticoagulants in patients with atrial nonvalvular atrial fibrillation and diabetes mellitus: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and safety of novel oral anticoagulants in patients with atrial nonvalvular atrial fibrillation and diabetes mellitus: a systematic review and meta-analysis |
| title_short | Efficacy and safety of novel oral anticoagulants in patients with atrial nonvalvular atrial fibrillation and diabetes mellitus: a systematic review and meta-analysis |
| title_sort | efficacy and safety of novel oral anticoagulants in patients with atrial nonvalvular atrial fibrillation and diabetes mellitus a systematic review and meta analysis |
| topic | New direct oral anticoagulants (NOACs) Warfarin Atrial fibrillation Diabetes Efficacy Safety |
| url | https://doi.org/10.1186/s12967-022-03652-9 |
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