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Efficacy and safety of direct oral anticoagulants with and without Aspirin_ A systematic review and Meta-analysis.pdf (3.25 MB)

Efficacy and safety of direct oral anticoagulants with and without aspirin: a systematic review and meta-analysis

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posted on 2024-03-14, 16:43 authored by Talal Almas, Adeena Musheer, Arooba Ejaz, Fahd Niaz Shaikh, Anousheh Awais Paracha, Fizza Raza, Maryam Sarwar Khan, Fahad Masood, Faiza Siddiqui, Saamia Raza, Muhammad Fahad Wasim, Muhammad Hasnain Mankani, Kaneez Fatima, Abdul Mannan Khan Minhas

Background: Various anticoagulant therapies are prescribed to patients under physicians' discretion and recently Direct Oral Anticoagulants(DOAC) have been under trials to evaluate their safety and efficacy. In addition to this, the regimen of DOACs and Aspirin is of keen interest as researchers continue to find an optimal regimen to treat blood clots in patients. This study is a systematic review and meta-analysis of randomized controlled trials and observational studies that asses the safety and efficacy of DOAC with and without Aspirin.

Methods: We queried MEDLINE and Cochrane CENTRAL from their inception to April 2021, for published and randomized controlled trials and observational studies in any language that compared dual (DOAC + ASA) therapy or mono (DOAC alone) therapy in patients with AF. The results from the studies were presented as risk ratios (RRs) with 95% confidence intervals (CIs) and were pooled using a random-effects model. Endpoints of interest included major bleeding, myocardial infarction (MI), major adverse cardiovascular events (MACEs), hospitalizations, all-cause mortality, and stroke.

Results: The risk of major bleeding was significantly lower in the DOAC alone group compared with DOAC plus aspirin group. Non-significant results were obtained (P value greater than 0.05) for other outcomes establishing that DOAC monotherapy was not superior to the combined regimen in reducing the risk of MACE, Stroke, Hospitalization, Death.

Conclusion: Among patients with NVAF (Non valvular Atrial Fibrillation) and VTE (Venous thromboembolism) receiving anticoagulation prophylaxis, in terms of safety profile our comparisons showed a statistically significant reduction in Major Bleeding in DOAC Alone group compared with DOAC Plus Aspirin.

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The original article is available at https://www.sciencedirect.com/

Published Citation

Almas T, et al. Efficacy and safety of direct oral anticoagulants with and without aspirin: a systematic review and meta-analysis. Int J Cardiol Heart Vasc. 2022;40:101016.

Publication Date

26 March 2022

PubMed ID

35355928

Department/Unit

  • Undergraduate Research

Publisher

Elsevier B.V.

Version

  • Published Version (Version of Record)