Author + information
- Mohit Turagam,
- Poonam Velagapudi,
- Venkat Vuddanda,
- Madhav Lavu,
- Mohammad-Ali Jazayeri,
- Valay Parikh,
- Tushar Tarun,
- Donita Atkins,
- Kul Aggarwal,
- Sudharani Bommana,
- Luigi Di Biase,
- Andrea Natale and
- Madhu Reddy
Background: Novel oral anticoagulants (NOACs) have been found to be safe and effective for the prevention of systemic thromboembolim (STE) in non-valvular atrial fibrillation (AF) but their experience in patients undergoing cardioversion (CV) is limited.
Methods: A comprehensive literature search comparing NOACs vs. VKAs in patients undergoing CV was performed using Pubmed, Ebsco and google scholar databases. A total of 6 eligible studies [2 randomized controlled trials (RCTs) and 4 post-hoc analysis data of RCTs] consisting of 7,030 patients (NOACs – 4112 and VKAs – 2918 patients) were included. Follow-up duration was 30 days.
Results: There was no significant difference in baseline characteristics or follow up between both groups. The pooled-analysis showed similar risk of STE (HR 0.81, 95% CI 0.38-1.76, P=0.6) and MBE (HR 0.98, 95% CI 0.50-1.93, P=0.95) between NOACs vs. VKAs (Figure 1A,B). There was also no difference in risk of intracranial bleeding (HR 1.1, 95% CI 0.18-6.8, P=0.9) and all-cause mortality (HR 0.68, 95% CI 0.24-1.87, P=0.45) between both groups (Figure 2A,B). Low degree of heterogeneity among studies was demonstrated by Cochrane q-statistic (I2 =0%).
Conclusions: In our meta-analysis, there is no difference in STE, MBE, ICH or all-cause mortality between NOACs when compared with VKA's in patients undergoing CV for AF.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias and Clinical EP: Anticoagulation Issues
Abstract Category: 6. Arrhythmias and Clinical EP: Other
Presentation Number: 1189-094
- 2017 American College of Cardiology Foundation