COMMENTARY

NOACs Best Warfarin in Mortality Meta-analysis

Samuel Z. Goldhaber, MD

Disclosures

May 27, 2016

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This is Dr Sam Goldhaber for the Clot Blog on theheart.org on Medscape, speaking to you from the American College of Cardiology meeting in Chicago.

Today I'm going to review the results of the recent meta-analysis of novel oral anticoagulants (NOACs) vs warfarin.[1] It's going to be for the interesting endpoint of mortality rather than the endpoint of stroke prevention in atrial fibrillation or treatment of deep vein thrombosis or pulmonary embolism.

In this meta-analysis, 13 randomized controlled trials were selected, and these trials compared NOACs vs warfarin, both for treating venous thromboembolism and for preventing stroke from atrial fibrillation. More than 100,000 patients were included. [The study] found a statistically significant 10% reduction in all-cause mortality and also in cardiovascular mortality among patients who were assigned in these randomized controlled trials to the NOACs as opposed to warfarin. There was also a 50% reduction in fatal bleeding among patients who were assigned to receive the NOACs rather than warfarin.

I think that this meta-analysis is important because all-cause mortality and cardiovascular mortality are probably two of the most important clinical trial endpoints we have, and the meta-analysis indicates that there is an important reduction in the mortality rate using NOACs rather than warfarin.

This is Dr Sam Goldhaber, signing off for the Clot Blog.

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