This meta-analysis of 3 randomized trials of patients with Afib found the 3 new oral anticoagulants (dabigatran, apixaban, rivaroxaban) reduced stroke/embolism by 22% (RR 0.78, CI 0.67 to 0.92), hemorrhagic stroke by 55% (RR 0.45, CI 0.31 to 0.68), mortality by 12% (CI 0.82 to 0.95) and vascular mortality by 13% (RR 0.87, CI 0.77 to 0.98), compared to warfarin. Major and GI bleeding were not significantly different between the groups. This meta-analysis confirms early enthusiasm for these agents in preventing afib-associated stroke, although cost and lack of reliable antidotes will continue to raise concerns for using these agents in all patients (abstract)
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