Efficacy And Safety Of Dabigatran And Rivaroxaban In The Treatment Of Patients With Nonvalvular Atrial Fibrillation

Background:Because of the high risk of thromboembolism in atrial fibrillation,both domestic and foreign guidelines recommend anticoagulant therapy as the basic treatment of atrial fibrillation.Relevant clinical trials have confirmed that the efficacy of the new oral anticoagulant is better than warfarin in the treatment of patients with nvaf,but there is still no study that directly compares different new oral anticoagulants.Objective:A meta-analysis was conducted to compare the efficacy and safety of dabigatran and rivaroxaban in the treatment of patients with nonvalvular atrial fibrillation(nvaf),providing reasonable evidence for the treatment of clinical atrial fibrillation.Methods:PubMed,Cochrane Library,Web of Science,cnki,and wanfang were searched by computer,and literatures on the therapeutic effect comparison of new oral anticoagulants in the treatment of patients with nvaf were searched until November,2019.Literature screening and quality evaluation,and analysis of data was performed using Rev Man 5.3 and Stata 16 software.Results:In terms of efficacy,there was no significant difference in the incidence of embolism in patients with nvaf(RR=1.03,95CI(0.95,1.12),P=0.44),ischemic stroke(RR=1.08,95%CI(0.99,1.18),P=0.07),or acute myocardial infarction(RR=1.04,95%CI(0.93,1.16),P=0.53).In terms of safety,dabigatran group compared with the rivaroxaban had lower rates of major bleeding(RR=0.73,95% CI(0.68,0.79),P <0.00001),intracranial bleeding(RR=0.54,95% CI(0.45,0.66),P < 0.00001),gastrointestinal bleeding(RR=0.79,95% CI(0.73,0.84),P < 0.00001),and all-cause mortality(RR=0.68,95% CI(0.53,0.88),P=0.004)in patients with nvaf.And the difference was statistically significant.Conclusions:1.The efficacy of dabigatran and rivaroxaban in the treatment of patients with nonvalvular atrial fibrillation is comparable.2.Compared with rivaroxaban,dabigatron has a better safety in treating patients with nonvalvular atrial fibrillation.