Meta-Analysis of Renal Function on the Safety and Efficacy of Novel Oral Anticoagulants for Atrial Fibrillation

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Abstract

Novel oral anticoagulants (NOACs) are safe and effective for the prevention of stroke or systemic embolism (S/SE) in atrial fibrillation. The efficacy and safety of NOACs compared with warfarin has not been systematically assessed in subjects with mild or moderate renal dysfunction. We performed a meta-analysis of the randomized clinical trials that compared efficacy and safety (major bleeding) outcomes of NOACs compared to warfarin for the treatment of nonvalvular atrial fibrillation and had available data on renal function. We estimated the pooled relative risk (RR) of S/SE and major bleeding in relation to renal function (assessed by baseline estimated glomerular filtration rate divided in 3 groups: normal [estimated glomerular filtration rate >80 ml/min], mildly impaired [50 to 80 ml/min], and moderate impairment [

Original languageEnglish (US)
Pages (from-to)69-75
Number of pages7
JournalAmerican Journal of Cardiology
Volume117
Issue number1
DOIs
StatePublished - Jan 1 2016

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Anticoagulants
Atrial Fibrillation
Meta-Analysis
Warfarin
Embolism
Glomerular Filtration Rate
Kidney
Safety
Hemorrhage
Randomized Controlled Trials
Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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abstract = "Novel oral anticoagulants (NOACs) are safe and effective for the prevention of stroke or systemic embolism (S/SE) in atrial fibrillation. The efficacy and safety of NOACs compared with warfarin has not been systematically assessed in subjects with mild or moderate renal dysfunction. We performed a meta-analysis of the randomized clinical trials that compared efficacy and safety (major bleeding) outcomes of NOACs compared to warfarin for the treatment of nonvalvular atrial fibrillation and had available data on renal function. We estimated the pooled relative risk (RR) of S/SE and major bleeding in relation to renal function (assessed by baseline estimated glomerular filtration rate divided in 3 groups: normal [estimated glomerular filtration rate >80 ml/min], mildly impaired [50 to 80 ml/min], and moderate impairment [",
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AU - Del-Carpio Munoz, Freddy

AU - Gharacholou, Shahyar

AU - Munger, Thomas M.

AU - Friedman, Paul Andrew

AU - Asirvatham, Samuel J

AU - Packer, Douglas L

AU - Noseworthy, Peter

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