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JAMA Clinical Evidence Synopsis |

Factor Xa Inhibitors vs Warfarin for Preventing Stroke and Thromboembolism in Patients With Atrial Fibrillation

Karsten M. H. Bruins Slot, MD, PhD1; Eivind Berge, MD, PhD1
[+] Author Affiliations
1Department of Internal Medicine, Oslo University Hospital, Oslo, Norway
JAMA. 2014;311(11):1150-1151. doi:10.1001/jama.2014.1403.
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Published online

Clinical Question  Is treatment with factor Xa inhibitors associated with better efficacy and safety compared with the vitamin K antagonist warfarin for preventing strokes or other systemic embolic events in patients with atrial fibrillation?

Bottom Line  Compared with warfarin, factor Xa inhibitors are associated with a lower risk of stroke and other systemic embolic events in patients with atrial fibrillation. Factor Xa inhibitors were associated with lower rates of intracranial hemorrhage and mortality compared with warfarin. Factor Xa inhibitors were associated with a reduction in major bleeding events, but there was heterogeneity between the included studies, and the reduction was not statistically significant in a prespecified sensitivity analysis.

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Figure.
Comparison of Factor Xa Inhibitors vs Warfarin for Prevention of Stroke and Systemic Embolic Events

Data have been adapted with permission from the Cochrane Collaboration.1 Odds ratios were calculated using the Mantel-Haenszel fixed-effect method. The size of the data markers indicate the weight of the study.

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