Effect of edoxaban compared with other oral anticoagulants for stroke prevention in patients with atrial fibrillation: A meta-analysis
Abstract
Current observational studies have compared the effectiveness and safety of edoxaban with other oral anticoagulants in patients with AF, but the results are still disputed. This meta-analysis was conducted to compare the effect of edoxaban in patients with AF. We performed systematic research from the PubMed, EMBASE, and Cochrane Library databases until November 2022 to obtain relevant observational studies. Adjusted risk ratios (RRs) and 95 % confidence intervals (CIs) of the outcomes were collected and pooled by a random-effects model. This study was prospectively registered in PROSPERO (CRD42022314222). A total of 17 observational studies were included in this meta-analysis. Compared with vitamin K antagonists, edoxaban was associated with lower risks of stroke or systemic embolism (RR = 0.67, 95 % CI:0.61–0.74), major bleeding (RR = 0.54, 95 % CI:0.44–0.67), and intracranial hemorrhage (RR = 0.51, 95 % CI:0.29–0.90). Compared with dabigatran or rivaroxaban, edoxaban was associated with reduced risks of stroke or systemic embolism (dabigatran [RR = 0.76, 95 % CI:0.66–0.87]; rivaroxaban [RR = 0.81, 95 % CI:0.70–0.94]) and major bleeding (dabigatran [RR = 0.82, 95 % CI:0.69–0.98]; rivaroxaban [RR = 0.81, 95 % CI:0.70–0.94]). Compared with apixaban, edoxaban was associated with a reduced risk of stroke or systemic embolism (RR = 0.87, 95 % CI:0.79–0.97), but had similar risks of bleeding events. Our current evidence suggested that edoxaban might have superior effectiveness and/or safety outcomes than vitamin K antagonists, dabigatran, rivaroxaban, and apixaban for stroke prevention in patients with AF.
- Publication:
-
Heliyon
- Pub Date:
- November 2023
- DOI:
- 10.1016/j.heliyon.2023.e21740
- Bibcode:
- 2023Heliy...921740Z
- Keywords:
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- Atrial fibrillation;
- Anticoagulants;
- Edoxaban;
- Vitamin K antagonists;
- Warfarin