Table 2.
Effectiveness and safety outcomes between NOACs and warfarin in dialysis patients with AF.
| Stroke or systemic embolism | Ischemic stroke | All-cause death | Major bleeding | Intracranial bleeding | Gastrointestinal bleeding | |
|---|---|---|---|---|---|---|
| Main analysis: mixed NOACs | ||||||
| No. of effect estimates | 6 | 4 | 2 | 5 | 3 | 4 |
| RRs and 95% CIs | 0.95 (0.68, 1.31) | 0.93 (0.55, 1.60) | 0.84 (0.71, 1.00) | 0.96 (0.65, 1.43) | 0.75 (0.50, 1.14) | 0.87 (0.74, 1.01) |
| P-value | 0.74 | 0.8 | 0.05 | 0.85 | 0.18 | 0.07 |
| I2 statistic | 51% | 41% | 0% | 89% | 0% | 0% |
| Secondary analysis: factor Xa inhibitors | ||||||
| No. of effect estimates | 4 | 3 | 2 | 4 | 3 | 4 |
| RRs and 95% CIs | 0.64 (0.41, 1.01) | 0.75 (0.39, 1.43) | 0.84 (0.71, 1.00) | 0.82 (0.52, 1.29) | 0.72 (0.48, 1.09) | 0.81 (0.70, 0.95) |
| P-value | 0.05 | 0.38 | 0.05 | 0.39 | 0.12 | 0.009 |
| I2 statistic | 57% | 34% | 0% | 83% | 0% | 0% |
| Subgroup analysis | ||||||
| 1) Rivaroxaban | ||||||
| No. of effect estimates | 3 | 2 | - | 3 | 1 | 2 |
| RRs and 95% CIs | 0.51 (0.22, 1.20) | 0.76 (0.26, 2.23) | - | 0.84 (0.43, 1.63) | 0.62 (0.24, 1.61) | 0.63 (0.41, 0.96) |
| Apixaban | ||||||
| No. of effect estimates | 2 | - | - | 1 | 2 | 2 |
| RRs and 95% CIs | 0.85 (0.68, 1.08) | - | - | 0.72 (0.59, 0.87) | 0.77 (0.49, 1.22) | 1.44 (0.43, 4.77) |
| 2) High dose of NOACs | ||||||
| No. of effect estimates | 1 | - | - | 3 | - | - |
| RRs and 95% CIs | 0.64 (0.42, 0.97) | - | - | 1.57 (0.63, 3.90) | - | - |
| Low dose of NOACs | ||||||
| No. of effect estimates | 3 | - | - | 5 | - | - |
| RRs and 95% CIs | 0.51 (0.18, 1.44) | - | - | 0.85 (0.56, 1.29) | - | - |
| Sensitivity analysis | ||||||
| 1) Only included adjusted data | ||||||
| No. of effect estimates | 2 | 1 | 1 | 4 | 2 | 2 |
| RRs and 95% CIs | 0.97 (0.73, 1.29) | 0.62 (0.24, 1.61) | 0.85 (0.71, 1.01) | 1.10 (0.74, 1.63) | 0.79 (0.51, 1.21) | 0.88 (0.75, 1.04) |
| P-value | 0.83 | - | - | 0.65 | 0.27 | 0.13 |
| I2 statistic | 30% | - | - | 90% | 0% | 0% |
| 2) Deleting the data of RCT | ||||||
| No. of effect estimates | 5 | 3 | 1 | 4 | 3 | 3 |
| RRs and 95% CIs | 1.02 (0.79, 1.32) | 1.14 (0.74, 1.77) | 0.85 (0.71, 1.01) | 1.10 (0.74, 1.63) | 0.75 (0.50, 1.14) | 0.87 (0.74, 1.01) |
| P-value | 0.89 | 0.55 | - | 0.65 | 0.18 | 0.07 |
| I2 statistic | 28% | 8% | - | 90% | 0% | 0% |
| 3) Re-analysis with a fixed-effects model | ||||||
| No. of effect estimates | 5 | 4 | 2 | 5 | 3 | 4 |
| RRs and 95% CIs | 0.95 (0.79, 1.14) | 1.02 (0.69, 1.51) | 0.84 (0.71, 1.00) | 1.05 (0.93, 1.18) | 0.75 (0.50, 1.14) | 0.87 (0.74, 1.01) |
| P-value | 0.58 | 0.92 | 0.05 | 0.46 | 0.18 | 0.07 |
| I2 statistic | 51% | 41% | 0% | 89% | 0% | 0% |
AF, atrial fibrillation; RR, risk ratio; CI, confidence interval; NOACs, non-vitamin K antagonist oral anticoagulants; RCT, Randomized Controlled Trial.