Article Text

Download PDFPDF
Systematic review and meta-analysis
Non-vitamin-K oral anticoagulants reduce mortality, stroke and intracranial haemorrhage when compared with warfarin in randomised trials of patients with non-valvular atrial fibrillation
  1. Benjamin A Steinberg
  1. Electrophysiology Section, Duke University Medical Center, Duke Clinical Research Institute, Durham, North Carolina, USA
  1. Correspondence to : Dr Benjamin A Steinberg, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27715, USA; benjamin.steinberg{at}

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Commentary on: OpenUrlCrossRefPubMedWeb of Science


Historically, the standard medication for stroke prevention in atrial fibrillation (AF) has been a vitamin-K antagonist (warfarin). However, several non-vitamin-K oral anticoagulants (NOACs) have been developed and shown to be at least as effective as dose-adjusted warfarin in their respective phase-3 clinical trials.1–4 These include the direct thrombin inhibitor dabigatran and the factor Xa inhibitors rivaroxaban, apixaban and edoxaban. Yet, despite these large trials, there remains limited power to examine certain end points and treatment effects in subgroups.


In a prespecified meta-analysis, the authors pooled trial-level data from the four existing phase-3 randomised clinical trials comparing a NOAC …

View Full Text


  • Competing interests BAS was funded by NIH T-32 training grant #5 T32 HL 7101-38, and reports significant research support from Janssen Pharmaceuticals, Inc.

  • Provenance and peer review Commissioned; internally peer reviewed.