UNASSIGNED: Non- @entity2067 antagonist oral anticoagulants (NOACs) are frequently used to prevent @entity64 in @entity1 with @entity955 . These @entity1 are often also on @entity117 or other antiplatelet agents. It is possible that treatment with both NOACs and @entity117 or other antiplatelet drug may be effective in decreasing @entity64 , but data are sparse regarding the efficacy and safety of using both agents for @entity64 prevention.To address these issues, data were pooled from the four recent randomized controlled trials of NOACs @entity5424 , @entity3925 , @entity3926 and @entity14242 , which included 42,411 @entity1 ; 14,148 (33.4%) were also on @entity117 or other antiplatelet drug. The number of @entity1031 among @entity1 on @entity15796 and @entity117 /antiplatelet was compared to the number of events in @entity1 on @entity15796 alone. Bleeding rates were also compared among those on @entity15796 + @entity117 /antiplatelet to @entity15796 alone. These results were compared to @entity1031 and @entity548 events in the @entity1229 + @entity117 /antiplatelet vs. @entity1229 alone. No greater risk for @entity1031 was seen in @entity1 on NOACs compared to @entity1 on both NOACs and @entity117 /antiplatelet drug. In this non-randomized comparison, there was initially a signal towards higher @entity1031 rates among @entity15796 users also on @entity117 /antiplatelet drugs (RR 1.16; 95% CI 1.05, 1.29) compared to @entity15796 alone. This likely reflected the higher CHADS2 scores of those on @entity117 /antiplatelet drugs. When the analysis was limited to studies that included @entity117 rather than other antiplatelet drugs, no difference was seen for @entity1031 rates comparing dual therapy to @entity15796 alone (RR 1.02; 95% CI 0.90, 1.15). Higher rates of @entity548 were seen with @entity117 /antiplatelet drug in conjunction with @entity15796 . In this meta-analysis and nonrandomized comparison of @entity117 /antiplatelet users and nonusers also on anticoagulation, there was no additional benefit seen of anticoagulation and antiplatelet therapy for @entity64 4 prevention compared to anticoagulation alone. There was, however, an increased risk of @entity548 . Careful assessment of the indications for antiplatelet drugs in @entity1 with @entity955 who are also receiving oral anticoagulation is warranted, and future randomized comparisons are needed.

Non-VKA Oral Anticoagulants and Antiplatelet Therapy for @entity64 Prevention in XXXX with @entity955 : a Meta-analysis of Randomized Controlled Trials.

@entity1 :: ('9606', 'Species') :: ['participants', 'patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity548 :: ('MESH:D006470', 'Disease') :: ['bleeding'] @entity2067 :: ('MESH:D014812', 'Chemical') :: ['vitamin K'] @entity117 :: ('MESH:D001241', 'Chemical') :: ['aspirin'] @entity3926 :: ('MESH:C554682', 'Chemical') :: ['dabigatran'] @entity3925 :: ('MESH:C503223', 'Chemical') :: ['rivaroxaban'] @entity5424 :: ('MESH:C522181', 'Chemical') :: ['apixaban'] @entity14242 :: ('MESH:C552171', 'Chemical') :: ['edoxaban'] @entity955 :: ('MESH:D001281', 'Disease') :: ['atrial fibrillation'] @entity1031 :: ('MESH:D013923', 'Disease') :: ['thromboembolism', 'thromboembolic', 'thromboembolic events'] @entity15796 :: ('MESH:C065145', 'Chemical') :: ['NOAC'] @entity1229 :: ('MESH:D014859', 'Chemical') :: ['warfarin']
@entity1 :: (9606,Species) :: ['Patients']
