Curative effect and safety of new oral anticoagulants in patients with coronary heart disease complicated by atrial fibrillation after PCI: a Meta-analysis
Guo Peiyan
Sun Guangcheng
Xie Lijuan
Li Ran
Zhou Birong
Abstract：Objective To conduct a Meta-analysis on the curative effect and safety of new oral anticoagulants (NOAC) in patients with coronary heart disease (CHD) complicated by atrial fibrillation (AF) after PCI, and to discuss the difference in curative effect and safety between NOAC and warfarin.Methods The related studies on curative effect and safety of NOAC compared with warfarin in patients with CHD complicated by AF were retrieved from databases of PubMed, EMbase and Cochrane, and then given a Meta-analysis by applying RevMan5.2 software.Results There were totally 6 studies chosen involving 5723 cases, and 3553 in test group and 2170in control group.The results of Meta-analysis showed that the difference in risks of in-stent thrombosis (OR=1.39, 95％CI:0.80～2.41, P=0.24, I2=0), recurrence of myocardial infarction (OR=1.07, 95％CI:0.78～1.46, P=0.69, I2=28.1), stroke (OR=1.11, 95％CI:0.70～1.76, P=0.66, I2=0) and death (OR=1.02, 95％CI:0.76～1.36, P=0.91, I2=0) had no statistical significance between test group and control group.The difference in major bleeding risks had statistical significance between 2 groups (OR=0.57, 95％CI:0.45～0.71, P＜0.00001, I2=0).Conclusion NOAC, compared with warfarin, can reduce major bleeding risk and does not increase the risks of in-stent thrombosis, recurrence of myocardial infarction, stoke and death at the same time in combined anticoagulation and antiplatelet treatment in patients with CHD complicated by AF.NOAC is as good as warfarin in clinical efficacy and has obvious advantages in safety compared with warfaring.
Keywords：New oral anticoagulantsWarfarinCoronary heart diseaseAtrial fibrillationPercutaneous coronary intervention
Publication Date：2018-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 1457-1462 )