The Efficacy And Safety Of New Oral Anticoagulants (NOACs) Versus Traditional Anticoagulants In Liver Cirrhosis: A Meta-Analysis

Objective To compare the efficacy and safety of new oral anticoagulants(NOACs)versus traditional anticoagulants for liver cirrhosis patients.Methods We systematically searched the PubMed,Embase,Cochran databases,CNKI,WANFANG,VIP and other databases until February 2,2020 to obtain relevant trials which met the inclusion criteria.A meta-analysis was performed on randomized controlled trials(RCTs)and non-randomized studies,and review manager software5.3 was used to conduct statistical analysis.Results Of the 2096 articles assessed,one RCT and six retrospective cohort studies were included in this analysis,involving 1677 NOACs and 1365 traditional anticoagulant users.Compared with the traditional anticoagulants group,the major bleeding rate was lower in NOACs group(OR=0.56,95%CI 0.37-0.85,P=0.006),and the embolism recanalization rate was higher(OR=7.77,95%CI 3.48-17.34,P <0.00001).There was no significant difference in the all-cause bleeding rates(OR=0.72,95%CI 0.13-3.91,P=0.070),the rate of all-cause mortality(OR=0.72,95%CI 0.25-2.07,P=0.54),and the recurrent embolism or stroke rate(OR=0.90,95%CI 0.59-1.39,P=0.64)between NOACs group and the traditional anticoagulants group.Conclusion Our study showed that in patients with liver cirrhosis,compared with the traditional anticoagulants,NOACs may have better efficacy and safety.