Comparative Effectiveness of Novel Oral Anticoagulants Versus Traditional Anticoagulants in Atrial Fibrillation Patients: A Narrative Review NOACs vs VKAs in Atrial Fibrillation

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Published: Sep 4, 2024
DOI: https://doi.org/10.61919/jhrr.v4i3.1446
Keywords:
Atrial fibrillation, novel oral anticoagulants, NOACs, vitamin K antagonists, VKAs, stroke prevention, meta-analysis, anticoagulation therapy, safety profile, clinical outcomes.

Main Article Content

Muhammad Ahsan Saeed
Shifa International Hospital, Islamabad, Pakistan.
Muhammad Rizwan
Shifa College of Medicine, Islamabad, Pakistan.
Uswa Hasana
Fatima Jinnah Medical University, Lahore, Pakistan.
Uzair Saeed
Fatima Jinnah Medical University, Lahore, Pakistan.
Ali Hamza
King Edward Medical University, Lahore, Pakistan.
Hamzah M. Alghzawi
Tennessee State University, Nashville, TN, USA.
Shah Bano
Sheikh Zayed Medical College, Rahim Yar Khan, Pakistan.
Saeedullah Asad
Fatima Jinnah Medical University, Lahore, Pakistan.

Abstract

Background: Atrial fibrillation (AF) increases the risk of stroke and systemic embolism, necessitating anticoagulation therapy. Traditional vitamin K antagonists (VKAs) like warfarin have limitations, prompting the use of novel oral anticoagulants (NOACs), which offer advantages like predictable dosing and fewer interactions.
Objective: To compare the effectiveness and safety of NOACs versus VKAs in AF patients.
Methods: A comprehensive literature search was conducted across PubMed, Cochrane CENTRAL, EMBASE, Web of Science, and Scopus to identify randomized controlled trials (RCTs) and observational studies published between 2014 and 2024. Data were synthesized using a random-effects model, with subgroup analyses based on patient characteristics. The primary outcomes included stroke, systemic embolism, and major bleeding.
Results: A total of 42 studies involving approximately 250,000 patients met the inclusion criteria. NOACs reduced the risk of stroke and systemic embolism by 19% (RR 0.81, 95% CI 0.75-0.87) and major bleeding by 16% (RR 0.84, 95% CI 0.79-0.90) compared to VKAs. NOACs also halved the risk of intracranial hemorrhage (RR 0.50, 95% CI 0.42-0.59).
Conclusion: NOACs offer comparable or superior efficacy in stroke prevention with a better safety profile than VKAs, supporting their broader adoption in clinical practice for AF patients.

Article Details

How to Cite
Muhammad Ahsan Saeed, Muhammad Rizwan, Uswa Hasana, Uzair Saeed, Ali Hamza, Hamzah M. Alghzawi, Shah Bano, & Saeedullah Asad. (2024). Comparative Effectiveness of Novel Oral Anticoagulants Versus Traditional Anticoagulants in Atrial Fibrillation Patients: A Narrative Review: NOACs vs VKAs in Atrial Fibrillation. Journal of Health and Rehabilitation Research, 4(3), 1–6. https://doi.org/10.61919/jhrr.v4i3.1446
Issue
Vol. 4 No. 3 (2024): Volume 4, Issue 3 - July to September 2024
Section
Articles
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This work is licensed under a Creative Commons Attribution 4.0 International License.

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