What are the effects of non-vitamin K antagonist oral anticoagulants compared to warfarin in patients with atrial fibrillation and valvular heart disease?
A systematic review and meta-analysis of Pan et al. (2017) concluded that non-vitamin K antagonist oral anticoagulants (NOACs) had a lower rate of stroke and systemic embolism compared to warfarin in patients with atrial fibrillation and valvular heart disease. Furthermore, NOACs had a lower risk of major bleeding compared to warfarin. Avezum et al. (2015) also found that the use of apixaban, a NOAC, was associated with a lower rate of stroke or systemic embolism and lower rates of major bleeding compared to warfarin in patients with atrial fibrillation and valvular heart disease.