Abstract
Background: Evidence on the safety and effectiveness of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation (AF) patients with cancer is rather limited, so we performed this meta-analysis to compare the efficacy and safety of NOACs with vitamin K antagonists (VKAs) in real-world patients with AF and cancer.
Highlights
Atrial Fibrillation (AF), inducing a five-fold increase in thromboembolic risk [1], is the most common cardiac arrhythmia
We performed a systematic search in PubMed and Embase electronic database until June 2020 for relevant studies comparing the effect of any Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) versus vitamin K antagonists (VKAs) in AF patients with cancer
As presented in figure 2 and figure S1, the rates of stroke or systemic embolism were 10.7% in patients treated with NOACs versus 12.9% in those on VKAs, showing the decreased risk of Systemic Embolism (SSE) for NOACs users compared with VKAs (RR, 0.79; 95% Confidence Intervals (CIs), 0.69-0.90; I2=86%)
Summary
Atrial Fibrillation (AF), inducing a five-fold increase in thromboembolic risk [1], is the most common cardiac arrhythmia. Cancer patients are at high risk of morbidity and mortality due to thrombosis and bleeding [8,9]. The risks of both thromboembolic and bleeding incidents are higher in AF patients with cancer compared to those free of cancer [10,11,12,13,14]. The optimization of anticoagulation therapy is important in reducing the risk of both thrombotic and bleeding complications in AF patients with cancer. Evidence on the safety and effectiveness of Non-Vitamin K Antagonist Oral Anticoagulants (NOACs) in Atrial Fibrillation (AF) patients with cancer is rather limited, so we performed this meta-analysis to compare the efficacy and safety of NOACs with vitamin K antagonists (VKAs) in real-world patients with AF and cancer
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