| Title |
Meta-analysis of efficacy and safety of apixaban and uninterrupted apixaban therapy compared to vitamin K antagonists in patients undergoing catheter ablation for atrial fibrillation
|
|---|---|
| Published in |
Journal of Interventional Cardiac Electrophysiology, October 2016
|
| DOI | 10.1007/s10840-016-0195-5 |
| Pubmed ID | |
| Authors |
Anene Ukaigwe, Pragya Shrestha, Paras Karmacharya, Sarah K. Hussain, Soraya Samii, Mario D. Gonzalez, Deborah Wolbrette, Gerald V. Naccarrelli |
| Abstract |
Apixaban is a Factor Xa inhibitor increasingly being used for stroke prevention in atrial fibrillation (AF). Although several studies have been done, the efficacy and safety of apixaban during the peri-procedural period of AF ablation remains unclear. We sought to systematically review pooled data from these various studies to evaluate thromboembolic and bleeding risks in patients undergoing catheter ablation for AF who are treated with apixaban (interrupted and uninterrupted). Studies comparing anticoagulation with apixaban or vitamin K antagonists (VKA) in patients undergoing ablation for AF were identified via an electronic search of MEDLINE, EMBASE, clinical trials.gov, and Cochrane Library from inception to January 2016. Study-specific risk ratios were calculated and combined with a fixed-effects model meta-analysis. In the analysis of 2100 pooled patients, thromboembolic complications (TE) occurred in 14/778 (1.80 %) patients in the apixaban group (AG) compared to 20/1322 patients in the VKA group (RR 1.03, 95 % CI 0.55-1.90, p = 0.93, I (2) = 0 %). Major bleeding occurred in 9/778 (1.2 %) of the AG compared to 20/1322 (1.51 %) in the VKA group (RR 1.03, 95 % CI 0.55-1.90, p = 0.93, I (2) = 0 %). In uninterrupted apixaban group (uAG), TE occurred in 4/585 (0.68 %) patients in the uAG compared to 6/910 (0.66 %) in VKA group (RR 0.86, 95 % CI 0.25-2.95, p = 0.81, I (2) = 0 %). Major bleeding occurred in 5/585 (0.85 %) in uAG compared to 7/910 (0.77 %) in the VKA group (RR 1.20, 95 % CI 0.37-3.88, p = 0.76, I (2) = 0 %). Our study demonstrates patients treated with apixaban and VKA during the peri-procedural period for AF ablation have similar rates of TE and bleeding complications. Interrupted and uninterrupted apixaban strategies were associated with similar outcomes. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Australia | 1 | 50% |
| United States | 1 | 50% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 1 | 50% |
| Science communicators (journalists, bloggers, editors) | 1 | 50% |
Mendeley readers
The data shown below were compiled from readership statistics for 47 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Slovenia | 1 | 2% |
| Unknown | 46 | 98% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 8 | 17% |
| Other | 4 | 9% |
| Student > Bachelor | 4 | 9% |
| Student > Ph. D. Student | 4 | 9% |
| Student > Postgraduate | 3 | 6% |
| Other | 6 | 13% |
| Unknown | 18 | 38% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 34% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 9% |
| Agricultural and Biological Sciences | 2 | 4% |
| Nursing and Health Professions | 2 | 4% |
| Biochemistry, Genetics and Molecular Biology | 1 | 2% |
| Other | 2 | 4% |
| Unknown | 20 | 43% |