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Appropriate doses of non-vitamin K antagonist oral anticoagulants in high-risk subgroups with atrial fibrillation: Systematic review and meta-analysis
DC Field | Value | Language |
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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 | 2018-10-22T13:15:05Z | - |
dc.date.available | 2018-10-22T13:15:05Z | - |
dc.date.issued | 2018 | - |
dc.identifier.issn | 0914-5087 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/163663 | - |
dc.description.abstract | BACKGROUND: We evaluated the dose-dependent efficacy, safety, and all-cause mortality of non-vitamin K antagonist oral anticoagulants (NOACs) in "atrial fibrillation (AF) patients who were OAC-naïve," or "AF patients with prior-stroke history" with those who were known to be high-risk subgroups under OAC. METHODS: After a systematic database search (Medline, EMBASE, CENTRAL, SCOPUS, and Web of Science), five phase-III randomized trials comparing NOACs and warfarin in "OAC-naïve/OAC-experienced," or "with/without prior-stroke history" subgroups were included. The outcomes were pooled using a random-effects model to determine the relative risk (RR) for stroke/systemic thromboembolism (SSTE), major bleeding, intracranial hemorrhage, and all-cause mortality. RESULTS: 1. In OAC-naïve patients, standard-dose NOACs showed superior efficacy and safety with lower mortality [RR 0.90 (0.84-0.97), p=0.008, I2=0%] compared to warfarin. 2. For OAC-experienced patients, low-dose NOACs showed equivalent efficacy but reduced risk of major bleeding [RR 0.61 (0.40-0.91), p=0.02, I2=89%], and had lower all-cause mortality [RR 0.86 (0.75-0.99), p=0.04, I2=38%] compared to warfarin. 3. For patients with prior-stroke history, low-dose NOACs showed equivalent efficacy, but reduced risk of major bleeding [RR 0.58 (0.48-0.70), p<0.001, I2=0%] and all-cause mortality [RR 0.76 (0.66-0.88), p<0.001, I2=0%] compared to warfarin. 4. Among patients without prior-stroke history, standard-dose NOAC was superior to warfarin for both SSTE prevention [RR 0.78 (0.66-0.91), p=0.002, I2=43%] and all-cause mortality [RR 0.91 (0.85-0.97), p=0.004, I2=0%]. CONCLUSIONS: In conclusion, standard-dose NOAC showed lower all-cause mortality than warfarin in OAC-naïve patients with AF, and low-dose NOAC was better than warfarin among the patients with prior-stroke history in terms of all-cause mortality. | - |
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 | Appropriate doses of non-vitamin K antagonist oral anticoagulants in high-risk subgroups with atrial fibrillation: 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.2018.03.009 | - |
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 | 29706404 | - |
dc.identifier.url | https://www.sciencedirect.com/science/article/pii/S0914508718300935 | - |
dc.subject.keyword | Atrial fibrillation | - |
dc.subject.keyword | Meta-analysis | - |
dc.subject.keyword | Non-vitamin K antagonist oral anticoagulant | - |
dc.subject.keyword | Oral anticoagulant-naïve | - |
dc.subject.keyword | Previous 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 | 4 | - |
dc.citation.startPage | 284 | - |
dc.citation.endPage | 291 | - |
dc.identifier.bibliographicCitation | JOURNAL OF CARDIOLOGY, Vol.72(4) : 284-291, 2018 | - |
dc.identifier.rimsid | 58964 | - |
dc.type.rims | ART | - |
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