SynthesisBMC cardiovascular disorders2025
Efficacy and safety of anticoagulants in elderly atrial fibrillation patients: a systematic review and network meta-analysis.
Synthesis in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- A real-world safety evaluation of new oral anticoagulants in elderly patients: evidence from the Adverse Drug Reaction Monitoring Center of Henan Province.Journal of pharmaceutical policy and practice · 2025Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAtrial fibrillation (AF) disproportionately affects elderly populations, raising concerns about balancing efficacy and safety in anticoagulation therapy.
objectiveTo assess the efficacy and safety of various anticoagulants in elderly AF patients through a systematic review and network meta-analysis.
methodsWe systematically searched PubMed, MEDLINE, Embase, and Web of Science for randomized controlled trials (RCTs) up to September 10, 2024, involving AF patients aged 75 years and older. Outcomes included stroke, major and non-major bleeding, all-cause mortality, and cardiovascular mortality. Statistical analysis was performed using a Bayesian random-effects network meta-analysis model to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Surface under the cumulative ranking curve (SUCRA) was used to rank treatments.
resultsFourteen RCTs involving 16,261 participants were included, with 13 RCTs analyzing stroke (14675 patients), 14 RCTs major bleeding (16261 patients), 6 RCTs non-major bleeding (1074 patients), 7 RCTs all-cause mortality (10128 patients), and 4 RCTs cardiovascular mortality (7704 patients). Edoxaban 15 mg once daily significantly reduced stroke incidence compared to warfarin (OR = 0.30, 95% CI: 0.12-0.71) and placebo (OR = 0.29, 95% CI: 0.20-0.42), ranking highest in stroke prevention (SUCRA = 90.6%). Dabigatran 110 mg twice daily reduced the risk of major bleeding (OR = 0.18, 95% CI: 0.04-0.76) compared to rivaroxaban 15 mg. Rivaroxaban 10 mg (OR = 0.35, 95% CI: 0.13-0.94) and edoxaban 15 mg (OR = 0.67, 95% CI: 0.46-0.99) demonstrated significant reductions in adverse events compared to placebo. No significant differences were observed across treatments for all-cause or cardiovascular mortality.
conclusionEdoxaban 15 mg and Rivaroxaban 10 mg provide an optimal balance between efficacy and safety in elderly AF patients. These findings support the need for personalized anticoagulant selection to maximize therapeutic benefit in this high-risk population.
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