{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T10:13:40Z","timestamp":1789726420617,"version":"4.0.1"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,4,21]],"date-time":"2024-04-21T00:00:00Z","timestamp":1713657600000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Science Reports"],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>Obesity affects nearly 650 million adults worldwide, and the prevalence is steadily rising. This condition has significant adverse effects on cardiovascular health, increasing the risk of hypertension, coronary artery disease, heart failure, and atrial fibrillation (AF).\u00a0While anticoagulation for obese patients with AF is a well\u2010established therapy for the prevention of thromboembolism, the safety and efficacy of different anticoagulants in this specific population are not well explored. This meta\u2010analysis aimed to compare direct oral anticoagulants (DOAC)\u00a0to vitamin K antagonists in obese populations with AF.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The PRISMA guidelines were followed for this meta\u2010analysis, registered in PROSPERO (CRD42023392711).\u00a0PubMed, PubMed Central, Embase, Cochrane Library, and Scopus databases were searched for relevant articles from inception through January 2023. Two independent authors screened titles and abstracts, followed by a full\u2010text review in Covidence. Data were extracted in Microsoft Excel and analyzed using RevMan v5.4 using odds ratio as an effect measure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Two thousand two hundred fifty\u2010nine\u00a0studies were identified from the database search, and 18 were included in the analysis. There were statistically significant reductions in the odds of ischemic and hemorrhagic stroke in the DOAC group compared with the VKA group (OR\u00a00.70, CI 0.66\u20130.75) and (OR\u00a00.47, CI 0.35\u20130.62), respectively. In addition, the DOAC group exhibited lower odds of systemic embolism (OR\u00a00.67, CI 0.54\u20130.83), major bleeding (OR\u00a00.62, CI 0.54\u20130.72), and composite outcome (OR\u00a00.72, CI 0.63\u20130.81).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Based on the findings from this meta\u2010analysis, DOACs demonstrate superior safety and efficacy in obese patients with AF compared with\u00a0VKAs. These results may have significant implications for guiding anticoagulation strategies in this patient population.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hsr2.2044","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T05:05:45Z","timestamp":1713762345000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Safety and efficacy of direct oral anticoagulants in comparison to warfarin in obese patients with atrial fibrillation: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"7","author":[{"given":"Alla","family":"Adelkhanova","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Mount Sinai Hospital Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prakash Raj","family":"Oli","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Province Hospital Birendranagar Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8121-083X","authenticated-orcid":false,"given":"Dhan Bahadur","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Mount Sinai Hospital Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jurgen","family":"Shtembari","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Mount Sinai Hospital Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivek","family":"Jha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine John H. 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