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. 2018 Mar 18;20(9):1399–1421. doi: 10.1093/europace/euy046

Table 7.

Meta-analyses examining anti-coagulation strategies in atrial fibrillation relating to stroke

Author Study design Outcome Inclusions/exclusions Risk
Hart et al.59 Meta-analysis adjusted-dose warfarin and aspirin Stroke 6 RCTs warfarin vs. placebo; n = 2900 RR 64% reduction, 95% CI 49–74%; Absolute reduction: 1° prevention 2.7% per year, 2° prevention 8.48% per year
7 RCTs aspirin vs. placebo or no Rx; n = 3900 RR 19% reduction, 95% CI −1 to 35%; 1° prevention 0.8% per year, 2° prevention 2.5% per year
8 RCTs warfarin vs. aspirin Rx; n = 3647 RR 38% reduction, 95% CI 18–52%; 1° prevention 0.7% per year, 2° prevention 7.0% per year
Ruff et al.60 Meta-analysis phase 3 RCTs: Stroke and systemic emboli n = 29 312 NOAC; n = 29 272 warfarin RR 0.81, 95% CI 0.73–0.91; P <0.0001; I2 = 47%; P = 0.13
RE-LY, ROCKET AF, ARISTOTLE, ENGAGE AF–TIMI 48 n = 41 257, no prior stroke; n = 17 269, prior stroke RR 0.85, 95% CI 0.72–1.01 RR 0.89; 95% CI 0.77–1.02; Pinteraction = 0.30
Ischaemic stroke n = 29 292 NOAC; n = 29 221 warfarin RR 0.92, 95% CI 0.83–1.02; P = 0.10; I2 = 32%; P = 0.22
Haemorrhagic stroke n = 29 292 NOAC; n = 29 221 warfarin RR 0.49, 95% CI 0.38–0.64; P < 0.0001; I2 = 34%; P = 0.21

H/o, history of; NOAC, non-vitamin K antagonist oral anticoagulant; RCT, randomized clinical trial; RR, relative risk.