Most Read Articles
01 Mar 2016
The present understanding on the pathogenesis, diagnosis, and management of rheumatic heart disease were discussed in a review.
05 Jun 2015
Acute rheumatic fever and rheumatic heart disease continue to cause serious problems and hospitalisations according to a study in Zimbabwe.
03 Jun 2017
Both high and low values of the atherogenic index of plasma are independently associated with all-cause mortality, a new study reveals.
18 Aug 2016
Chronic kidney disease (CKD), regardless of the stage, appears to have no direct effect on cardiovascular mortality within 180 days and 2 years from digoxin treatment initiation in treatment-naïve patients with non-valvular atrial fibrillation (AF), a Danish cohort study suggests.

NOACs more effective than warfarin, safer in Asians

03 Jul 2017

Regardless of dosing, nonvitamin K antagonist oral anticoagulants (NOACs) are more effective than warfarin for atrial fibrillation (AF) and safer in Asian than in non-Asian populations, a new meta-analysis shows.

Randomized controlled trials (RCTs) that compared the efficacy of any NOAC with warfarin in Asian patients with nonvalvular AF were searched from the databases of PubMed, CINAHL and CENTRAL. Only those that employed standard NOAC doses were included.

Among the information extracted were efficacy and safety outcomes, study design, sample characteristics and management details. The Cochrane Collaboration tool for detecting risk of bias was used.

After applying the selection criteria, six RCTs (n=6,496) were included in the meta-analysis. Of all the participants, 1,114 were treated with NOACs once-daily while 2,137 were treated twice-daily. The remaining 3,245 received warfarin.

Compared to dose-matched warfarin, the risk of stroke or systemic embolism was lower in Asian (risk ratio [RR], 0.74; 95 percent CI, 0.53 to 1.04) and non-Asian (RR, 0.90; 0.80 to 1.01) patients who received a once-daily dose of NOACs.

Similarly, the risk of stroke or systemic embolism in Asian (RR, 0.63; 0.47 to 0.83) and non-Asian (RR, 0.82; 0.71 to 0.94) patients was lower for twice-daily NOACs than for warfarin. None of the associations reached statistical significance, however.

On the other hand, the risk of bleeding in Asian patients (RR, 0.63; 0.47 to 0.85) was significantly lower than in non-Asian patients (RR, 0.93; 0.84 to 1.02; p=0.015) for the once-daily NOACs. Risk of bleeding from twice-daily NOACs was also significantly lower in Asian patients (RR, 0.57; 0.43 to 0.75) than in non-Asian patients (RR, 0.84; 0.77 to 0.93; p=0.007).

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Most Read Articles
01 Mar 2016
The present understanding on the pathogenesis, diagnosis, and management of rheumatic heart disease were discussed in a review.
05 Jun 2015
Acute rheumatic fever and rheumatic heart disease continue to cause serious problems and hospitalisations according to a study in Zimbabwe.
03 Jun 2017
Both high and low values of the atherogenic index of plasma are independently associated with all-cause mortality, a new study reveals.
18 Aug 2016
Chronic kidney disease (CKD), regardless of the stage, appears to have no direct effect on cardiovascular mortality within 180 days and 2 years from digoxin treatment initiation in treatment-naïve patients with non-valvular atrial fibrillation (AF), a Danish cohort study suggests.