Myocardial infarction and atrial fibrillation: Different impact of anti-IIa vs anti-Xa new oral anticoagulants. A meta-analysis of the interventional trials

INTERNATIONAL JOURNAL OF CARDIOLOGY

卷:178

Letter

Loffredo, Lorenzo¹  Perri, Ludovica¹  Violi, Francesco¹ 

[1] Univ Roma La Sapienza, Dept Internal Med & Med Specialties, I-00185 Rome, Italy

关键词: Atrial fibrillation;    New oral anticoagulants;    Myocardial infarction;   

DOI  :  10.1016/j.ijcard.2014.10.124

来源: Elsevier

【 摘 要 】

Purpose: The aim of this study was to perform a meta-analysis, in patients with atrial fibrillation, to evaluate the impact of new oral anticoagulants (NOACs) anti-IIa and anti-Xa vs warfarin on myocardial infarction incidence. Methods: A meta-analysis of double blind randomized controlled trials (RCTs) was performed. Results: Four RCT studies including 84,439 patients were selected. Compared with warfarin, no significant reduction of myocardial infarction was observed with anti-Xa drugs; conversely, myocardial infarction was significantly increased with anti-IIa NOAC (1.45% vs 1.04% respectively; RR: 1.38; 95% CI, 1.1-1.7; p = 0.005). Conclusions: This meta-analysis suggests that in patients with atrial fibrillation, compared to standard therapy with warfarin, treatment with anti-IIa NOAC is associated with a higher incidence of myocardial infarction. (C) 2014 Elsevier Ireland Ltd. All rights reserved.

【 授权许可】

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