TY - JOUR AU - Gu, Zhi-Chun AU - Kong, Ling-Cong AU - Yang, Shuo-Fei AU - Wei, An-Hua AU - Wang, Na AU - Ding, Zheng AU - Zhang, Chi AU - Liu, Xiao-Yan AU - Zheng, Ying-Li AU - Lin, Hou-Wen PY - 2019 TI - 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 JF - Cardiovascular Diagnosis and Therapy; Vol 9, No 5 (October 22, 2019): Cardiovascular Diagnosis and Therapy Y2 - 2019 KW - N2 - 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 Conclusions: NOACs, compared with warfarin, provide a better clinical profile on SSE, major bleeding, all-cause death, and NCB in CKD patients. UR - https://cdt.amegroups.org/article/view/28258