Anthony P Carnicelli, Hwanhee Hong, Stuart J Connolly, John Eikelboom, Robert P Giugliano, David A Morrow, Manesh R Patel, Lars Wallentin, John H Alexander, M Cecilia Bahit, Alexander P Benz, Erin A Bohula, Tze-Fan Chao, Leanne Dyal, Michael Ezekowitz, Keith A A Fox, Baris Gencer, Jonathan L Halperin, Ziad Hijazi, Stefan H Hohnloser, Kaiyuan Hua, Elaine Hylek, Eri Toda Kato, Julia Kuder, Renato D Lopes, Kenneth W Mahaffey, Jonas Oldgren, Jonathan P Piccini, Christian T Ruff, Jan Steffel, Daniel Wojdyla, Christopher B Granger
BACKGROUND: Direct oral anticoagulants (DOACs) are preferred over warfarin for stroke prevention in atrial fibrillation. Meta-analyses using individual patient data offer substantial advantages over study-level data. METHODS: We used individual patient data from the COMBINE AF (A Collaboration Between Multiple Institutions to Better Investigate Non-Vitamin K Antagonist Oral Anticoagulant Use in Atrial Fibrillation) database, which includes all patients randomized in the 4 pivotal trials of DOACs versus warfarin in atrial fibrillation (RE-LY [Randomized Evaluation of Long-Term Anticoagulation Therapy], ROCKET AF [Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared With Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation], ARISTOTLE [Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation], and ENGAGE AF-TIMI 48 [Effective Anticoagulation With Factor Xa Next Generation in Atrial Fibrillation-Thrombolysis in Myocardial Infarction 48]), to perform network meta-analyses using a stratified Cox model with random effects comparing standard-dose DOAC, lower-dose DOAC, and warfarin...
January 25, 2022: Circulation