{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T09:42:47Z","timestamp":1768556567972,"version":"3.49.0"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2017,5,4]],"date-time":"2017-05-04T00:00:00Z","timestamp":1493856000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2017,9]]},"abstract":"Oral anticoagulation (OAC<\/jats:styled-content>) is recommended in both paroxysmal atrial fibrillation (pxAF<\/jats:styled-content>) and nonparoxysmal AF<\/jats:styled-content> (non\u2010pxAF<\/jats:styled-content>), but disagreement exists in classes of recommendation. Data on incidence\/rate of stroke in pxAF<\/jats:styled-content> are conflicting, and OAC<\/jats:styled-content> is often underused in this population. The objectives of the meta\u2010analysis were to investigate different impact on outcomes of pxAF<\/jats:styled-content> and non\u2010pxAF<\/jats:styled-content>, with and without OAC<\/jats:styled-content>. Two reviewers searched for prospective studies on risk of stroke and systemic embolism (SE<\/jats:styled-content>) in pxAF<\/jats:styled-content> and non\u2010pxAF<\/jats:styled-content>, with and without OAC<\/jats:styled-content>. Quality of evidence was assessed according to GRADE<\/jats:styled-content> approach. Stroke combined with SE<\/jats:styled-content> was the main outcome. Meta\u2010regression was performed to evaluate OAC<\/jats:styled-content> effect on stroke and SE<\/jats:styled-content> incidence rate. We identified 18 studies. For a total of 239\u2009528 patient\u2010years of follow\u2010up. The incidence rate of stroke\/SE<\/jats:styled-content> was 1.6% (95% confidence interval [CI<\/jats:styled-content>]: 1.3%\u20102.0%) in pxAF<\/jats:styled-content> and 2.3% (95% CI<\/jats:styled-content>: 2.0%\u20102.7%) in non\u2010pxAF<\/jats:styled-content>. Paroxysmal AF<\/jats:styled-content> was associated with a lower risk of overall thromboembolic (TE<\/jats:styled-content>) events (risk ratio: 0.72, 95% CI<\/jats:styled-content>: 0.65\u20100.80, P<\/jats:italic> < 0.00001) compared with non\u2010pxAF<\/jats:styled-content>. In both groups, the annual rate of TE<\/jats:styled-content> events decreased as proportion of patients treated with OAC<\/jats:styled-content> increased. Non\u2010pxAF<\/jats:styled-content> showed a reduction from 3.7% to 1.7% and pxAF<\/jats:styled-content> from 2.5% to 1.2%. Major bleeding rates did not differ among groups. Stroke\/SE<\/jats:styled-content> risk is significantly lower, although clinically meaningful, in pxAF<\/jats:styled-content>. OAC<\/jats:styled-content> consistently reduces TE<\/jats:styled-content> event rates across any AF<\/jats:styled-content> pattern. As a whole, these data provide the evidence to warrant OAC<\/jats:styled-content> irrespective of the AF<\/jats:styled-content> pattern in most (virtually all) patients.<\/jats:p>","DOI":"10.1002\/clc.22701","type":"journal-article","created":{"date-parts":[[2017,5,4]],"date-time":"2017-05-04T14:02:53Z","timestamp":1493906573000},"page":"641-647","source":"Crossref","is-referenced-by-count":12,"title":["Thromboembolic risk and effect of oral anticoagulation according to atrial fibrillation patterns: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9263-286X","authenticated-orcid":false,"given":"Alessio","family":"Lilli","sequence":"first","affiliation":[{"name":"Emergency Department, Cardiology Versilia Hospital, Lido di Camaiore Lucca Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Di Cori","sequence":"additional","affiliation":[{"name":"Second Division of 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