| 000 | 04722nam a22008297a 4500 | ||
|---|---|---|---|
| 008 | 161101s20162016 xxu||||| |||| 00| 0 eng d | ||
| 022 | _a0167-5273 | ||
| 040 | _aOvid MEDLINE(R) | ||
| 099 | _a26709135 | ||
| 245 | _aComparison of Watchman device with new oral anti-coagulants in patients with atrial fibrillation: A network meta-analysis. | ||
| 251 | _aInternational Journal of Cardiology. 205:17-22, 2016 Feb 15. | ||
| 252 | _aInt J Cardiol. 205:17-22, 2016 Feb 15. | ||
| 253 | _aInternational journal of cardiology | ||
| 260 | _92016 Feb 15 | ||
| 260 | _c2016 | ||
| 260 | _f2016 | ||
| 266 | _d2017-03-06 | ||
| 520 | _aBACKGROUND: New oral anticoagulants (NOAC) and the Watchman device represent an alternative to warfarin for stroke prophylaxis in atrial fibrillation (AF) patients. However, no studies compare these new treatments. We performed a network meta-analysis to indirectly compare Watchman and NOACs among AF patients. | ||
| 520 | _aCONCLUSIONS: NOAC therapy was superior to warfarin for multiple outcomes while Watchman reduced hemorrhagic stroke. Further studies are needed to assess Watchman versus NOAC to optimize therapy for stroke prevention in AF patients.Copyright (c) 2015 Elsevier Ireland Ltd. All rights reserved. | ||
| 520 | _aMETHODS: We performed a MEDLINE search for studies comparing warfarin with NOACs (dabigatran, rivaroxaban, apixaban and edoxaban) or Watchman in AF patients with reported clinical outcomes. Mixed treatment comparison model generation was performed to directly and indirectly compare NOACs, warfarin and Watchman. | ||
| 520 | _aRESULTS: 14 studies with 246,005 patients were included in the analysis, among which 124,823 were treated with warfarin, 120,450 were treated with NOACs and 732 had Watchman implanted. Mean age was 72 +/- 9 years, 53% were male, and mean CHADS2 score was 2.1 +/- 1.6. Both NOACs and Watchman were superior to warfarin in hemorrhagic stroke prevention (OR = 0.46 [0.30-0.82] and OR = 0.21 [0.05-0.99], respectively). NOACs significantly reduced total stroke (OR = 0.78 [0.58-0.96]) and major bleeding (OR = 0.78 [0.65-0.91]) compared with warfarin. Indirect comparison between NOAC and Watchman revealed no significant differences in outcomes, though there was a trend toward higher rates of ischemic stroke with Watchman compared with NOAC (OR 2.60 [0.60-13.96]) with the opposite findings with hemorrhagic stroke (OR = 0.44 [0.09-2.14]). | ||
| 546 | _aEnglish | ||
| 650 | _a*Anticoagulants/ad [Administration & Dosage] | ||
| 650 | _a*Atrial Fibrillation/th [Therapy] | ||
| 650 | _a*Defibrillators, Implantable/st [Standards] | ||
| 650 | _aAdministration, Oral | ||
| 650 | _aAnticoagulants/ae [Adverse Effects] | ||
| 650 | _aAtrial Fibrillation/di [Diagnosis] | ||
| 650 | _aAtrial Fibrillation/ep [Epidemiology] | ||
| 650 | _aClinical Trials as Topic/mt [Methods] | ||
| 650 | _aDabigatran/ad [Administration & Dosage] | ||
| 650 | _aDabigatran/ae [Adverse Effects] | ||
| 650 | _aDefibrillators, Implantable/ae [Adverse Effects] | ||
| 650 | _aHemorrhage/ci [Chemically Induced] | ||
| 650 | _aHumans | ||
| 650 | _aPyrazoles/ad [Administration & Dosage] | ||
| 650 | _aPyrazoles/ae [Adverse Effects] | ||
| 650 | _aPyridines/ad [Administration & Dosage] | ||
| 650 | _aPyridines/ae [Adverse Effects] | ||
| 650 | _aPyridones/ad [Administration & Dosage] | ||
| 650 | _aPyridones/ae [Adverse Effects] | ||
| 650 | _aThiazoles/ad [Administration & Dosage] | ||
| 650 | _aThiazoles/ae [Adverse Effects] | ||
| 650 | _aWarfarin/ad [Administration & Dosage] | ||
| 650 | _aWarfarin/ae [Adverse Effects] | ||
| 651 | _aMedStar Washington Hospital Center | ||
| 651 | _aMedStar Washington Hospital Center | ||
| 651 | _aMedStar Washington Hospital Center | ||
| 651 | _aMedStar Washington Hospital Center | ||
| 651 | _aMedStar Washington Hospital Center | ||
| 651 | _aMedStar Washington Hospital Center | ||
| 651 | _aMedStar Washington Hospital Center | ||
| 656 | _aMedStar Heart Institute | ||
| 656 | _aMedStar Heart Institute | ||
| 656 | _aMedStar Heart Institute | ||
| 656 | _aMedStar Heart Institute | ||
| 656 | _aMedStar Heart Institute | ||
| 656 | _aMedStar Heart Institute | ||
| 656 | _aMedStar Heart Institute | ||
| 657 | _aComparative Study | ||
| 657 | _aJournal Article | ||
| 657 | _aMeta-Analysis | ||
| 700 | _aDidier, Romain | ||
| 700 | _aEscarcega, Ricardo O | ||
| 700 | _aKiramijyan, Starkis | ||
| 700 | _aKoifman, Edward | ||
| 700 | _aLipinski, Michael J | ||
| 700 | _aTorguson, Rebecca | ||
| 700 | _aWaksman, Ron | ||
| 790 | _aDidier R, Escarcega RO, Kiramijyan S, Koifman E, Lipinski MJ, Torguson R, Waksman R | ||
| 942 |
_cART _dArticle |
||
| 999 |
_c1978 _d1978 |
||