Arrhythmias & electrophysiology

Direct Oral Anticoagulants for Stroke Prevention in Patients With Device-Detected Atrial Fibrillation: A Study-Level Meta-Analysis of the NOAH-AFNET 6 and ARTESiA Trials

CirculationPublished Systematic review and meta-analysis of randomised trials

Pooled result · Ischemic strokeResult — go to the resultRelative risk 0.68 95% CI 0.50–0.92

Authors' conclusion

Meta-analysis of these 2 large randomized trials provides high-quality evidence that oral anticoagulation with edoxaban or apixaban reduces the risk of stroke in patients with device-detected atrial fibrillation and increases the risk of major bleeding.

Study context

Population
Adults with device-detected AF recorded by a pacemaker, ICD, CRT device or implanted cardiac monitor2 RCTs
Comparison
OAC vs antiplatelet or no antithrombotic therapy
Outcome
Ischemic stroke
Methodological detailsrandom-effects, GRADE, preregistered
  • Random-effects
  • GRADE
  • Preregistered

Pooled result

As reported in the abstract

Relative risk

0.68

95% CI 0.50–0.92

OACvs Antiplatelet or no antithrombotic therapy
RR 0.68 (95% CI 0.50–0.92)

Further pooled results

OutcomeRR (95% CI)
Composite of CV death, all-cause stroke, peripheral arterial embolism, MI or PEI2=0%; moderate-quality evidence0.85 (0.73–0.99)

CV death

No reduction in CV death

All-cause mortality

No reduction in all-cause mortality

Safety

OutcomeRR (95% CI)
Major bleedingI²=61%; high-quality evidence1.62 (1.05–2.50)

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Direct Oral Anticoagulants for Stroke Prevention in Patients With Device-Detected Atrial Fibrillation: A Study-Level Meta-Analysis of the NOAH-AFNET 6 and ARTESiA Trials. Circulation. Published 12 November 2023. doi:10.1161/circulationaha.123.067512

Composed by AI from the published abstract and checked against it. How Briefs are made →

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