Discussion
ur sadly wae designed to compare the eficacy and
safey’of new oral anticeagulans Wo that of warfarin in
patents with AF. Our systematic seach identified 3 vials,
valuating the sew eral aaticoagulans apitaban” dabiga=
tran? and ivaroxaban* In ur meta-atalys, we found that
(he sew oral ancongilants dove te nk for co
cd point of sek and sytem embolion compara to
‘warfarin, New orl anticoagulants were aso found to be
sSvoviaed with a lower tsk fr Key sceondaryeffcacy
‘outcomes including heme ani uneatifed stoke, hem
‘rmaglesuoke, all-cause motaty, and vascular orally,
Compared to warfarin. Out meteanalyis was inclusive
‘ot conclusive, may decreae the overall risk for major
Dlceding events kn paints with AF. In catrast our Fesulis
suggest the porslity of an increased risk for gastromtes-
tina blcoding associated withthe new agent
‘Several phase Il trials have demonstrated citer a com-
paraile tik or a sedesed tend of maj and clin
relevant blceding assisted with the new agents compared
to warfarin. Edocaban, a now factor Xa inhibitor, wes a
socited with similar bleeding risks as warfarin in patients
IwithAP atonce-dily dovagen he cficacy ad safety at
these dosages a being investigated ina large phse I
‘ported a decreed incidence of major and clinically rl
trot bleeding events in pation rosving apna Coo
fal to thse rcivng walrin™ AZDXSS7. other aew
{Erect thrombin nbn ha ako show tend toward
lower rss for major and liically yeevant Blcding at
spre deus in peste with AF“! Aiitional ston
{se requied to confim thew findings and to assess the
SHicny of ie matthews doae Im painter acate
‘encusthomboanbolism,dbigatan was assocated witha
ncaa Tower sik formar and lineal eleva
beeling compared to warfsin* Studies of aptabae and
‘ivapsabn inflict afer acute venous thembocmbo-
lismsbowed comparabic risks for Heading to lew-melecs
Jar weight heparm followed bya viamin K antagonist
[Wis imporant to note tht polished rates of map bleding
sscociated with varfarin are have been found to undeest
‘at the rik inal practic.” Thi sd tothe wndarep-
‘escalation of eller paints who have a higher Hk for
‘hajer coding eyes in clial als
‘Our sly ha 3 potenti mito. Fit there was
hotewgencty attong the locked tal They examined