ReviewCureus2024
Safety of Non-vitamin K Antagonist Oral Anticoagulants on Outcomes After Transcatheter Aortic Valve Replacement: An Updated Meta-Analysis.
Review in Cureus, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
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Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The existing evidence on the use of non-vitamin K oral anticoagulants (NOACs) after transcatheter aortic valve replacement (TAVR) surgery is inconclusive and contradictory. Likewise, major society guidelines remain ambivalent about NOAC use around the time of TAVR. The objective of our meta-analysis was to assess the efficacy of NOACs in comparison to vitamin K antagonists (VKAs) in lowering complications following TAVR. An electronic literature search was conducted using MEDLINE, EMBASE, the international clinical trials database, and Cochrane Library. The primary endpoint was all-cause mortality, and the secondary endpoints included cardiovascular-related death, myocardial infarction, all-cause stroke, and various bleeding events. Forest plots were constructed for the pooled analysis of data. Subgroup and sensitivity analyses were also performed. No significant difference was noted between the NOAC and VKA groups with respect to the risk of all-cause mortality (14.14% vs. 20.28%; risk ratio (RR): 0.82; 95% confidence interval (CI): 0.61 to 1.10; p = 0.18), cardiovascular-related deaths (6.10% vs. 8.55%; RR: 1.02; 95% CI: 0.78 to 1.33; p = 0.91), myocardial infarction (1.52% vs. 2.51%; RR: 1.13; 95% CI: 0.50 to 2.56; p = 0.77), all-cause stroke (2.74% vs. 2.68%; RR: 1.02; 95% CI: 0.75 to 1.39; p = 0.89), major bleeding (7.74% vs. 9.62%; RR: 0.97; 95% CI: 0.58 to 1.61; p = 0.90), minor clinically relevant bleeding (14.33% vs. 13.73%; RR: 0.91; 95% CI: 0.67 to 1.24; p = 0.55), and other bleeding events. The risk of intracranial hemorrhage was lower in the NOAC group than in the VKA group (0.45% vs. 0.67%; RR: 0.61; 95% CI: 0.42 to 0.88; p = 0.008). Our study found NOACs to be non-inferior to VKAs in several outcomes, such as all-cause mortality, cardiovascular-related deaths, myocardial infarction, all-cause stroke, and bleeding events. In fact, NOACs were favored over VKAs, as the VKA group had a higher risk of developing intracranial hemorrhage.
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