Cited 46 times in
Non-vitamin K antagonist oral anticoagulants have better efficacy and equivalent safety compared to warfarin in elderly patients with atrial fibrillation: A systematic review and meta-analysis.
DC Field | Value | Language |
---|---|---|
dc.contributor.author | 김인수 | - |
dc.contributor.author | 김태훈 | - |
dc.contributor.author | 박희남 | - |
dc.contributor.author | 엄재선 | - |
dc.contributor.author | 이문형 | - |
dc.contributor.author | 정보영 | - |
dc.date.accessioned | 2018-09-28T08:49:59Z | - |
dc.date.available | 2018-09-28T08:49:59Z | - |
dc.date.issued | 2018 | - |
dc.identifier.issn | 0914-5087 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/163130 | - |
dc.description.abstract | BACKGROUND: To evaluate the efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) in elderly patients (aged ≥75 years) with atrial fibrillation (AF), depending on dose and/or renal function. METHODS: After systematically searching the databases (Medline, EMBASE, CENTRAL, SCOPUS, and Web of Science), 5 phase III randomized controlled trials and reported data according to subgroups of elderly/non-elderly AF patients, comparing any NOACs and warfarin were included. The primary efficacy and safety outcomes were stroke/systemic thromboembolism and major bleeding. RESULTS: (1) NOACs showed better efficacy than warfarin in elderly patients [RR 0.83 (0.69-1.00), p=0.04, I2=55%], but equivalent efficacy in non-elderly patients. (2) NOACs reduced major bleeding compared to warfarin in non-elderly (p<0.001) and had comparable safety to warfarin in elderly patients. (3) Even in elderly patients with moderately impaired renal function, NOACs had a safety profile comparable to that of warfarin for major bleeding if dose reduction was reached appropriately [pooled RR 0.82 (0.35-1.88), p=0.63, I2=63%]. (4) All-cause mortality was lower with NOACs in non-elderly patients [RR 0.89 (0.83-0.95), p=0.001, I2=0%], and with standard-dose NOAC group of elderly patients [RR 0.93 (0.86-1.00), p=0.04, I2=0%] compared to warfarin. CONCLUSIONS: For elderly patients (aged ≥75 years), NOACs showed better efficacy and equivalent safety compared to warfarin even in those with moderately impaired renal function. All-cause mortality was lower with standard-dose NOACs compared to warfarin in the elderly patient group. SYSTEMATIC REVIEW REGISTRATION: The protocol of this meta-analysis was registered on PROSPERO under CRD42016047922 (https://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016047922). | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | Japanese, English | - |
dc.publisher | Elsevier | - |
dc.relation.isPartOf | JOURNAL OF CARDIOLOGY | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.rights | https://creativecommons.org/licenses/by-nc-nd/2.0/kr/ | - |
dc.title | Non-vitamin K antagonist oral anticoagulants have better efficacy and equivalent safety compared to warfarin in elderly patients with atrial fibrillation: A systematic review and meta-analysis. | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine | - |
dc.contributor.department | Dept. of Internal Medicine | - |
dc.contributor.googleauthor | In-Soo Kim | - |
dc.contributor.googleauthor | Hyun-Jung Kim | - |
dc.contributor.googleauthor | Tae-Hoon Kim | - |
dc.contributor.googleauthor | Jae-Sun Uhm | - |
dc.contributor.googleauthor | Boyoung Joung | - |
dc.contributor.googleauthor | Moon-Hyoung Lee | - |
dc.contributor.googleauthor | Hui-Nam Pak | - |
dc.identifier.doi | 10.1016/j.jjcc.2018.01.015 | - |
dc.contributor.localId | A00840 | - |
dc.contributor.localId | A05466 | - |
dc.contributor.localId | A01776 | - |
dc.contributor.localId | A02337 | - |
dc.contributor.localId | A02766 | - |
dc.contributor.localId | A03609 | - |
dc.relation.journalcode | J01287 | - |
dc.identifier.eissn | 1876-4738 | - |
dc.identifier.pmid | 29519547 | - |
dc.identifier.url | https://www.sciencedirect.com/science/article/pii/S0914508718300479 | - |
dc.subject.keyword | Atrial fibrillation | - |
dc.subject.keyword | Elderly | - |
dc.subject.keyword | Meta-analysis | - |
dc.subject.keyword | Non-vitamin K antagonist oral anticoagulants | - |
dc.subject.keyword | Stroke | - |
dc.contributor.alternativeName | Kim, In Soo | - |
dc.contributor.alternativeName | Kim, Tae-Hoon | - |
dc.contributor.alternativeName | Pak, Hui Nam | - |
dc.contributor.alternativeName | Uhm, Jae Sun | - |
dc.contributor.alternativeName | Lee, Moon Hyoung | - |
dc.contributor.alternativeName | Joung, Bo Young | - |
dc.contributor.affiliatedAuthor | Kim, In Soo | - |
dc.contributor.affiliatedAuthor | Kim, Tae Hoon | - |
dc.contributor.affiliatedAuthor | Pak, Hui Nam | - |
dc.contributor.affiliatedAuthor | Uhm, Jae Sun | - |
dc.contributor.affiliatedAuthor | Lee, Moon Hyoung | - |
dc.contributor.affiliatedAuthor | Joung, Bo Young | - |
dc.citation.volume | 72 | - |
dc.citation.number | 2 | - |
dc.citation.startPage | 105 | - |
dc.citation.endPage | 112 | - |
dc.identifier.bibliographicCitation | JOURNAL OF CARDIOLOGY, Vol.72(2) : 105-112, 2018 | - |
dc.identifier.rimsid | 58401 | - |
dc.type.rims | ART | - |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.