SynthesisClinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
Comparing the Direct Oral Anticoagulants versus Vitamin K Antagonists in Bioprosthetic Valves: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Synthesis in Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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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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.
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Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BackgroundReplacing bioprosthetic valves is common but can cause coagulation issues. This study assesses the safety and efficacy of Direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKAs) in bioprosthetic valve procedures.MethodsPubMed, Cochrane Central, and ScienceDirect were searched till May 2025. The risk ratios (RRs) were pooled with 95% confidence intervals (CIs) under the random effects model using Review Manager software. The quality assessment was conducted using the Cochrane risk of bias (RoB 2.0) tool.ResultsEight randomized controlled trials involving 3863 patients were included in the meta-analysis. DOACs were associated with a significant reduction in the risk of stroke or systemic embolism compared with VKAs (RR = 0.48; 95%CI: [0.26, 0.88]; p = .02). The rate of major bleeding was similar between the DOACs and VKAs (RR = 0.92; 95%CI: [0.49, 1.72]; p = .79). There was no significant difference in the incidence of any stroke between the two groups (RR = 0.65; 95%CI: [0.32, 1.31]; p = .23). The occurrence of clinically relevant non-major bleeding (RR = 1.17; 95%CI: [0.97, 1.40]; p = .10), all-cause mortality (RR = 0.94; 95%CI: [0.75, 1.17]; p = .57), and intracranial hemorrhage (ICH) (RR = 0.71; 95%CI: [0.40, 1.26]; p = .25) were comparable between the groups.ConclusionDOACs seem safe after bioprosthetic valve implantation, lowering the risk of stroke or systemic embolism. However, rates of major bleeding, clinically relevant non-major bleeding, any stroke, ICH, and all-cause mortality were comparable between DOACs and VKAs.
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