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Lower Major Bleeding Rates with Direct Oral Anticoagulants in Catheter Ablation of Atrial Fibrillation: an Updated Meta-analysis of Randomized Controlled Studies

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Lower Major Bleeding Rates with Direct Oral Anticoagulants in Catheter Ablation of Atrial Fibrillation: an Updated Meta-analysis of Randomized Controlled Studies. / Brunetti, Natale Daniele; Tricarico, Lucia; Tilz, Roland R; Heeger, Christian-H; De Gennaro, Luisa; Correale, Michele; Ieva, Riccardo; Di Biase, Matteo; Rillig, Andreas; Metzner, Andreas; Santoro, Francesco.

In: CARDIOVASC DRUG THER, Vol. 34, No. 2, 04.2020, p. 209-214.

Research output: SCORING: Contribution to journal › SCORING: Review article › Research

Harvard

Brunetti, ND, Tricarico, L, Tilz, RR, Heeger, C-H, De Gennaro, L, Correale, M, Ieva, R, Di Biase, M, Rillig, A, Metzner, A & Santoro, F 2020, 'Lower Major Bleeding Rates with Direct Oral Anticoagulants in Catheter Ablation of Atrial Fibrillation: an Updated Meta-analysis of Randomized Controlled Studies', CARDIOVASC DRUG THER, vol. 34, no. 2, pp. 209-214. https://doi.org/10.1007/s10557-020-06947-5

APA

Brunetti, N. D., Tricarico, L., Tilz, R. R., Heeger, C-H., De Gennaro, L., Correale, M., Ieva, R., Di Biase, M., Rillig, A., Metzner, A., & Santoro, F. (2020). Lower Major Bleeding Rates with Direct Oral Anticoagulants in Catheter Ablation of Atrial Fibrillation: an Updated Meta-analysis of Randomized Controlled Studies. CARDIOVASC DRUG THER, 34(2), 209-214. https://doi.org/10.1007/s10557-020-06947-5

Vancouver

Brunetti ND, Tricarico L, Tilz RR, Heeger C-H, De Gennaro L, Correale M et al. Lower Major Bleeding Rates with Direct Oral Anticoagulants in Catheter Ablation of Atrial Fibrillation: an Updated Meta-analysis of Randomized Controlled Studies. CARDIOVASC DRUG THER. 2020 Apr;34(2):209-214. https://doi.org/10.1007/s10557-020-06947-5

Bibtex

@article{ec17112a554f4d6f94c6819e87a2bf32,
title = "Lower Major Bleeding Rates with Direct Oral Anticoagulants in Catheter Ablation of Atrial Fibrillation: an Updated Meta-analysis of Randomized Controlled Studies",
abstract = "INTRODUCTION: Catheter ablation (CA) of atrial fibrillation (AF) is an important rhythm control strategy for patients with drug-refractory AF. We aimed to perform an updated meta-analysis of direct oral anticoagulants (DOACs) vs vitamin K antagonists (VKAs) as uninterrupted anticoagulation in patients undergoing AF ablation to assess safety and efficacy of DOAC, after the publication of recent data on edoxaban in CA of AF.METHODS: We performed a meta-analysis of RCTs enrolling patients undergoing AF ablation. We assessed Mantel-Haenszel pooled estimates of risk ratios (RRs) and 95% CIs for thromboembolic events, major bleeding (MB), and non-major bleeding (NMB).RESULTS: A total of 2118 patients have been included in the analysis. Compared with patients receiving VKA, patients receiving DOACs had a lower, although non-significant, risk of thromboembolic events (RR, 0.40; 95% CI, 0.09-1.76; P = 0.23). MB rates in patients treated with DOACs were statistically significantly lower than VKA (RR, 0.61; 95% CI, 0.39-0.93, P = 0.02). The incidence of NMB was not significantly different (RR, 0.98; 95% CI, 0.83-1.57, p n.s.).CONCLUSIONS: In a meta-analysis of RCTs, an uninterrupted DOACs strategy for CA of AF appears to be superior to uninterrupted VKA in terms of safety; a non-significant trend favoring DOACs in terms of efficacy is also evident.",
keywords = "Administration, Oral, Anticoagulants/administration & dosage, Atrial Fibrillation/diagnosis, Catheter Ablation/adverse effects, Factor Xa Inhibitors/administration & dosage, Female, Hemorrhage/chemically induced, Humans, Male, Middle Aged, Randomized Controlled Trials as Topic, Risk Assessment, Risk Factors, Thromboembolism/diagnosis, Time Factors, Treatment Outcome, Vitamin K/antagonists & inhibitors, Warfarin/administration & dosage",
author = "Brunetti, {Natale Daniele} and Lucia Tricarico and Tilz, {Roland R} and Christian-H Heeger and {De Gennaro}, Luisa and Michele Correale and Riccardo Ieva and {Di Biase}, Matteo and Andreas Rillig and Andreas Metzner and Francesco Santoro",
year = "2020",
month = apr,
doi = "10.1007/s10557-020-06947-5",
language = "English",
volume = "34",
pages = "209--214",
journal = "CARDIOVASC DRUG THER",
issn = "0920-3206",
publisher = "Kluwer Academic Publishers",
number = "2",

}

RIS

TY - JOUR

T1 - Lower Major Bleeding Rates with Direct Oral Anticoagulants in Catheter Ablation of Atrial Fibrillation: an Updated Meta-analysis of Randomized Controlled Studies

AU - Brunetti, Natale Daniele

AU - Tricarico, Lucia

AU - Tilz, Roland R

AU - Heeger, Christian-H

AU - De Gennaro, Luisa

AU - Correale, Michele

AU - Ieva, Riccardo

AU - Di Biase, Matteo

AU - Rillig, Andreas

AU - Metzner, Andreas

AU - Santoro, Francesco

PY - 2020/4

Y1 - 2020/4

N2 - INTRODUCTION: Catheter ablation (CA) of atrial fibrillation (AF) is an important rhythm control strategy for patients with drug-refractory AF. We aimed to perform an updated meta-analysis of direct oral anticoagulants (DOACs) vs vitamin K antagonists (VKAs) as uninterrupted anticoagulation in patients undergoing AF ablation to assess safety and efficacy of DOAC, after the publication of recent data on edoxaban in CA of AF.METHODS: We performed a meta-analysis of RCTs enrolling patients undergoing AF ablation. We assessed Mantel-Haenszel pooled estimates of risk ratios (RRs) and 95% CIs for thromboembolic events, major bleeding (MB), and non-major bleeding (NMB).RESULTS: A total of 2118 patients have been included in the analysis. Compared with patients receiving VKA, patients receiving DOACs had a lower, although non-significant, risk of thromboembolic events (RR, 0.40; 95% CI, 0.09-1.76; P = 0.23). MB rates in patients treated with DOACs were statistically significantly lower than VKA (RR, 0.61; 95% CI, 0.39-0.93, P = 0.02). The incidence of NMB was not significantly different (RR, 0.98; 95% CI, 0.83-1.57, p n.s.).CONCLUSIONS: In a meta-analysis of RCTs, an uninterrupted DOACs strategy for CA of AF appears to be superior to uninterrupted VKA in terms of safety; a non-significant trend favoring DOACs in terms of efficacy is also evident.

AB - INTRODUCTION: Catheter ablation (CA) of atrial fibrillation (AF) is an important rhythm control strategy for patients with drug-refractory AF. We aimed to perform an updated meta-analysis of direct oral anticoagulants (DOACs) vs vitamin K antagonists (VKAs) as uninterrupted anticoagulation in patients undergoing AF ablation to assess safety and efficacy of DOAC, after the publication of recent data on edoxaban in CA of AF.METHODS: We performed a meta-analysis of RCTs enrolling patients undergoing AF ablation. We assessed Mantel-Haenszel pooled estimates of risk ratios (RRs) and 95% CIs for thromboembolic events, major bleeding (MB), and non-major bleeding (NMB).RESULTS: A total of 2118 patients have been included in the analysis. Compared with patients receiving VKA, patients receiving DOACs had a lower, although non-significant, risk of thromboembolic events (RR, 0.40; 95% CI, 0.09-1.76; P = 0.23). MB rates in patients treated with DOACs were statistically significantly lower than VKA (RR, 0.61; 95% CI, 0.39-0.93, P = 0.02). The incidence of NMB was not significantly different (RR, 0.98; 95% CI, 0.83-1.57, p n.s.).CONCLUSIONS: In a meta-analysis of RCTs, an uninterrupted DOACs strategy for CA of AF appears to be superior to uninterrupted VKA in terms of safety; a non-significant trend favoring DOACs in terms of efficacy is also evident.

KW - Administration, Oral

KW - Anticoagulants/administration & dosage

KW - Atrial Fibrillation/diagnosis

KW - Catheter Ablation/adverse effects

KW - Factor Xa Inhibitors/administration & dosage

KW - Female

KW - Hemorrhage/chemically induced

KW - Humans

KW - Male

KW - Middle Aged

KW - Randomized Controlled Trials as Topic

KW - Risk Assessment

KW - Risk Factors

KW - Thromboembolism/diagnosis

KW - Time Factors

KW - Treatment Outcome

KW - Vitamin K/antagonists & inhibitors

KW - Warfarin/administration & dosage

U2 - 10.1007/s10557-020-06947-5

DO - 10.1007/s10557-020-06947-5

M3 - SCORING: Review article

C2 - 32080786

VL - 34

SP - 209

EP - 214

JO - CARDIOVASC DRUG THER

JF - CARDIOVASC DRUG THER

SN - 0920-3206

IS - 2

ER -