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Net clinical benefit of non-vitamin K antagonist oral anticoagulants in atrial fibrillation and chronic kidney disease: a trade-off analysis from four phase III clinical trials

  
@article{CDT28258,
	author = {Zhi-Chun Gu and Ling-Cong Kong and Shuo-Fei Yang and An-Hua Wei and Na Wang and Zheng Ding and Chi Zhang and Xiao-Yan Liu and Ying-Li Zheng and Hou-Wen Lin},
	title = {Net clinical benefit of non-vitamin K antagonist oral anticoagulants  in atrial fibrillation and chronic kidney disease: a trade-off analysis  from four phase III clinical trials},
	journal = {Cardiovascular Diagnosis and Therapy},
	volume = {9},
	number = {5},
	year = {2019},
	keywords = {},
	abstract = {Background: Atrial fibrillation (AF) is quite prevalent in patient with chronic kidney disease (CKD). This study mainly investigated the net clinical benefit (NCB) property of non-vitamin K antagonist oral anticoagulants (NOACs) versus warfarin in patients with AF and CKD by a pooled-analysis.
Methods: A comprehensive search of Medline, Embase, Cochrane Library and Clinical Trials.gov Website was performed for eligible randomized controlled trials (RCTs) reporting the efficacy and safety outcomes according to renal function of NOACs. Pre-specified outcomes and their number of patients needed to treat (NNT), including stroke/systemic embolism (SSE), major bleeding, and all-cause death, were evaluated using a random-effects model. NCB that balanced SSE and major bleeding was calculated using Singer’s method.
Results: Four phase III clinical trials including 70,952 patients were enrolled, 45,265 (64%) with CKD, and 25,687 (36%) without CKD; 41,942 (59%) taking NOACs and 29,010 (41%) taking warfarin. Risks of SSE [relative risk (RR): 0.80, 95% confidence interval (CI): 0.73–0.88, P},
	issn = {2223-3660},	url = {http://cdt.amegroups.com/article/view/28258}
}