Abstract
Abstract Background: This systematic review and meta-analysis investigate the effects of dabigatran compared to traditional warfarin on major bleeding events in patients with atrial fibrillation. By synthesising data from relevant studies, this analysis aims to provide insights into the comparative safety profiles of these anticoagulant medications in managing atrial fibrillation. Materials and Methods: The search strategy focused on electronic databases using keywords related to dabigatran, warfarin and atrial fibrillation, with a language restriction to English. Quality assessment was conducted using the Newcastle–Ottawa Scale to evaluate bias in the selected studies. The study selection criteria included retrospective trials comparing bleeding complications between dabigatran and warfarin in atrial fibrillation patients. Data extraction and quality assessment were conducted independently by two investigators. Statistical analyses were performed using R software to assess heterogeneity and risk ratios, employing both random-effects and common-effect models for comprehensive insights. Results: The meta-analysis revealed a significant association between dabigatran and major bleeding events compared to warfarin, yet with notable heterogeneity across studies. While no significant publication bias was evident, caution was warranted due to uncertainty in certain estimates. The variability in study quality underscored the need for meticulous methodological appraisal. Conclusions: These findings enhance our understanding of anticoagulant safety profiles, guiding clinical practice and future research in the management of atrial fibrillation.
Published Version
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