Anzeige
Erschienen in:
12.01.2017 | REVIEWS
New oral anticoagulants compared to warfarin for perioperative anticoagulation in patients undergoing atrial fibrillation catheter ablation: a meta-analysis of continuous or interrupted new oral anticoagulants during ablation compared to interrupted or continuous warfarin
Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 3/2017
Einloggen, um Zugang zu erhaltenAbstract
Background
New oral anticoagulants (NOACs) have been shown to be comparable to warfarin in patients with non-valvular atrial fibrillation (AF). This meta-analysis was performed to evaluate the efficacy and safety of NOACs for perioperative anticoagulation of AF catheter ablation.
Methods
PubMed, Embase, the Cochrane Library, CNKI, VIP, and SinoMed were searched for articles published up to August 30, 2015. The data were calculated with RevMan 5.2 using a fixed-effects model.
Results
Nineteen studies with a total of 7996 patients were included in this meta-analysis. NOAC treatment was associated with fewer overall bleeding events than continuous warfarin treatment (RR = 0.78, 95% CI = 0.64–0.95, P = 0.01); similarly, there were fewer overall bleeding events with NOAC treatment than interrupted warfarin treatment (RR = 0.58, 95% CI = 0.44–0.77, P = 0.0002). In the subgroup analyses, the incidence of overall bleeding events (RR = 0.67, 95% CI = 0.48–0.92, P = 0.01) and minor bleeding events (RR = 0.56, 95% CI = 0.37–0.86, P = 0.007) in the interrupted NOAC group was lower than that in the continuous warfarin group. NOAC treatment did not increase the risk of thromboembolic complications compared with warfarin treatment (P > 0.05).
Conclusions
The findings of this meta-analysis suggested that periprocedural NOAC therapy was as effective as continuous warfarin therapy for preventing thromboembolism and had a lower incidence of bleeding complications. Interrupted NOAC therapy during the periprocedural period might result in a lower incidence of bleeding complications compared with continuous NOAC therapy.