Comparative efficacy and safety of apixaban and rivaroxaban versus warfarin in atrial fibrillation patients with end-stage renal disease: a systematic review and meta-analysis.
Xiaoyuan Wu, Jie Meng, Yu Yang et al.
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In 30 seconds
This systematic review and meta-analysis evaluated the efficacy and safety of apixaban and rivaroxaban compared to vitamin K antagonists in patients with atrial fibrillation undergoing dialysis. The analysis included three randomized controlled trials and eight observational studies. Apixaban and rivaroxaban were associated with lower risks of major bleeding (RR 0.57) and gastrointestinal bleeding (RR 0.66) compared to VKAs.
Key findings
- Apixaban and rivaroxaban reduced major bleeding risk (RR 0.57, 95% CI: 0.51-0.63) compared to VKAs.
- Gastrointestinal bleeding risk was lower with apixaban and rivaroxaban (RR 0.66, 95% CI: 0.57-0.76).
- The risk of stroke/systemic embolism was reduced (RR 0.57, 95% CI: 0.46-0.72) with apixaban and rivaroxaban.
Why it matters
Understanding the comparative safety and efficacy of anticoagulants in patients with end-stage renal disease is crucial, as these patients are at high risk for both thromboembolic events and bleeding complications. This study provides insights that may influence anticoagulation management in this vulnerable population.