META-Analysis Of Satety And Efficacy Of New Anticoagulants Versus Warfarin In Patients With Atrial Fibrillation

Objective: Atrial fibrillation is a common arrhythmia,and is one kind of stroke.It causes death and damage easily.In recent years,the number of patients with af incidence,mortality rate also increased year by year.In this article,through meta-analysis new anticoagulant drugs with traditional anticoagulant warfarin contrast the security of the treatment of atrial fibrillation,anticoagulant therapy in patients with atrial fibrillation new anticoagulant drugs for the safety and efficacy,in order to provide reference for clinical decision as a guidance for clinical medication.Method: Through CNKI,Wanfang Data,Medline,PubMed,EMBASE,the Cochrane,to search the papers that published for new anticoagulant drugs VS traditional anticoagulant drug warfarin in patients with atrial fibrillation.There are 235 articles about the New Anticoagulants,compared with Warfarin in patients for atrial fibrillation from 1990 to 2015.According to the inclusion criteria and exclusion criteria,extracting the data,using the RevMan5.2 software to calculate the all-cause mortality,myocardial infarction rate,rate of cerebral apoplexy,intracranial hemorrhage rate and incidence of peripheral artery and gastrointestnal bleeding rate.Results: In these papers,including 63888 patients.In the comparison of all-cause mortality,has included four studies [6,7,8,10],after RevMan5.2software analysis,draw(P = 0.01,the ratio OR = 0.01,95% confidence interval(CI)(0.86,0.98)],the results was lower than those of warfarin control group obviously.In the comparison of stoke,has included four studies [6,7,8,10],after RevMan5.2 software analysis,draw(P = 0.02,the ratio OR = 0.84,95% confidence interval(CI)(0.73,0.97)],the results that stoke was lower than those of warfarin control group obviously.In the comparison of intracranial bleeding has included four studies [6,7,8,9,10],after RevMan5.2software analysis,draw(P<0.0001,the ratio OR = 0.60,95% confidence interval(CI)(0.47,0.77))],the results was lower than those of warfarin control group obviously.In the comparison of all-cause mortality,has included four studies [6,7,8,9],after RevMan5.2 software analysis,draw(P =0.01,the ratio OR = 0.01,95% confidence interval(CI)(0.86,0.98)],the results of visible darby and ester group,cutting class,the pp o shaaban all-cause mortality was lower than those of warfarin control group obviously.In the comparison of Peripheral artery embolism,has included four studies [6,7,8,9],after RevMan5.2 software analysis,draw(P =0.0007,the ratio OR = 0.81,95% confidence interval(CI)(0.72,0.92)],the results was lower than those of warfarin control group obviously.In the comparison of AMI,has included four studies [6,7,8],after RevMan5.2 software analysis,draw(P =0.31,the ratio OR = 0.53,95% confidence interval(CI)(0.15,1.81)],the results was the same than those of warfarin control group obviously.In the comparison of intracranial hemorrhage,has included four studies [6,7,8],after RevMan5.2 software analysis,draw(P = 0.23,the ratio OR = 0.81,95%confidence interval(CI)(0.90,1.55)],the results was the same than those of warfarin control group obviously.Conclusion(s):Anticoagulant drugs can effectively prevent af embolism risk,at the same time increase the risk of bleeding.A new oral anticoagulant drugs without detecting INR,but must carefully assess the risk of hemorrhage and thrombosis risk.New oral anticoagulant drugs not only effectively reduces the risk of atrial fibrillation and stroke death,also reduces the risk of intracranial hemorrhage,gastrointestinal bleeding and thrombosis,security and efficacy are higher than traditional warfarin anticoagulant drugs.