TY - JOUR T1 - 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 JF - Evidence Based Medicine JO - Evid Based Med SP - 182 LP - 182 DO - 10.1136/ebmed-2014-110004 VL - 19 IS - 5 AU - Benjamin A Steinberg Y1 - 2014/10/01 UR - http://ebm.bmj.com/content/19/5/182.abstract N2 - Commentary on: Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014;383:955–62.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 … ER -