ReviewClinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
Discrepant Outcomes of Direct Oral Anticoagulant Trials in Device-Detected Atrial Fibrillation after Stroke: Insights from NOAH-AFNET 6 and ARTESIA.
Review 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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Abstract
The management of device-detected atrial fibrillation in patients with a history of stroke or transient ischemic attack remains a clinical dilemma, balancing the potential benefits of stroke prevention against the risks of anticoagulant-related bleeding. This review synthesizes evidence from the NOAH-AFNET 6 and ARTESIA trials, which evaluated the efficacy and safety of direct oral anticoagulants in this population. Collectively, randomized evidence regarding the use of direct oral anticoagulants in patients with device-detected atrial fibrillation and a history of stroke or transient ischemic attack remains limited and internally discordant. In ARTESIA, apixaban was associated with a reduction in ischemic stroke accompanied by an increase in major bleeding, yielding a relatively coherent benefit-risk signal in this high-risk subgroup. In contrast, NOAH-AFNET 6 demonstrated a modest and statistically non-significant reduction in ischemic stroke alongside a substantial increase in major bleeding. Further research is still needed to refine patient selection and optimize therapeutic strategies.
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