Projects per year
Abstract
Older people, are underrepresented in randomised controlled trials of direct oral anticoagulants (DOACs) for stroke prevention in atrial fibrillation (AF). The aim of this study was to combine data from observational studies to provide evidence for the treatment of people aged ≥75 years. Medline, Embase, Scopus and Web of Science were searched. The primary effectiveness outcome was ischaemic stroke. Safety outcomes were major bleeding, intracranial haemorrhage, gastrointestinal bleeding, myocardial infarction, and mortality. Twenty-two studies were eligible for inclusion. Two studies related specifically to people ≥75 years but were excluded from meta-analysis due to low quality; all data in the meta-analyses were from subgroups. The pooled risk estimate of ischaemic stroke was slightly lower for DOACs. There was no significant difference in major bleeding, mortality, or myocardial infarction. Risk of intracranial haemorrhage was 44% lower with DOACs, but risk of GI bleeding was 46% higher. Our results suggest that DOACs may be preferable for the majority of older patients with AF, provided they are not at significant risk of a GI bleed. However, these results are based entirely on data from subgroup analyses so should be interpreted cautiously. There is a need for adequately powered research in this patient group.
Original language | English |
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Article number | 554 |
Number of pages | 21 |
Journal | Journal of Clinical Medicine |
Volume | 8 |
Issue number | 4 |
DOIs | |
Publication status | Published - 24 Apr 2019 |
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Dive into the research topics of 'Effectiveness and Safety of Direct Oral Anticoagulants versus Vitamin K Antagonists for People Aged 75 Years and over with Atrial Fibrillation: A Systematic Review and Meta-Analyses of Observational Studies'. Together they form a unique fingerprint.Projects
- 1 Finished
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A Comparison of the Effectiveness and Safety of Direct Oral Anticoagulants and Warfarin in Older People with Atrial Fibrillation
Mitchell, A. (PI), McGrogan, A. (CoI) & Watson, M. (CoI)
18/09/17 → 17/09/20
Project: UK charity
Profiles
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Anita McGrogan
- Department of Life Sciences - Senior Lecturer
- EPSRC Centre for Doctoral Training in Statistical Applied Mathematics (SAMBa)
- Centre for Therapeutic Innovation
Person: Research & Teaching