Most Read Articles
02 Dec 2017
The risk of congenital heart disease (CHD) Is significantly higher in foetuses conceived through in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), according to a recent study.
Pearl Toh, 4 days ago
A higher dose of pitavastatin can benefit Japanese patients with stable coronary artery disease (CAD) compared with a low-dose pitavastatin, even though cardiovascular (CV) event incidence is known to be lower in Asian than Western patients, according to the REAL-CAD study presented at the AHA Scientific Sessions 2017.
01 Apr 2014
The basic life support (BLS) termination of resuscitation (TOR) rule recommends transport and continued resuscitation when cardiac arrest is witnessed by EMT-Ds, or there is a return of spontaneous circulation, or a shock is given.
03 Dec 2017
Treatment with the triple combination of amlodipine, losartan and rosuvastatin appears to be an effective therapeutic strategy for lowering blood pressure and low-density lipoprotein (LDL)-C levels in patients with comorbid hypertension and dyslipidaemia, according to a study.

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
02 Dec 2017
The risk of congenital heart disease (CHD) Is significantly higher in foetuses conceived through in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), according to a recent study.
Pearl Toh, 4 days ago
A higher dose of pitavastatin can benefit Japanese patients with stable coronary artery disease (CAD) compared with a low-dose pitavastatin, even though cardiovascular (CV) event incidence is known to be lower in Asian than Western patients, according to the REAL-CAD study presented at the AHA Scientific Sessions 2017.
01 Apr 2014
The basic life support (BLS) termination of resuscitation (TOR) rule recommends transport and continued resuscitation when cardiac arrest is witnessed by EMT-Ds, or there is a return of spontaneous circulation, or a shock is given.
03 Dec 2017
Treatment with the triple combination of amlodipine, losartan and rosuvastatin appears to be an effective therapeutic strategy for lowering blood pressure and low-density lipoprotein (LDL)-C levels in patients with comorbid hypertension and dyslipidaemia, according to a study.