{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T08:34:16Z","timestamp":1787906056183,"version":"build-2784847793"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T00:00:00Z","timestamp":1617235200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background and Purpose:<\/jats:title>\n                    <jats:p>Several observational studies have compared the effect of the non\u2013vitamin K antagonist oral anticoagulants to each other in patients with atrial fibrillation. However, confounding by indication is a major problem when comparing non\u2013vitamin K antagonist oral anticoagulant treatments in some of these studies. This meta-analysis was conducted to compare the effectiveness and safety between non\u2013vitamin K antagonist oral anticoagulant and non\u2013vitamin K antagonist oral anticoagulant by only including the propensity score matching studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We systematically searched the PubMed and Ovid databases until May 2020 to identify relevant observational studies. Hazard ratios (HRs) and 95% CIs of the reported outcomes were collected and then pooled by a random-effects model complemented with an inverse variance heterogeneity or quality effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 17 retrospective cohort studies were included in this meta-analysis. Compared with dabigatran use, the use of rivaroxaban was significantly associated with increased risks of stroke or systemic embolism (HR, 1.16 [95% CI, 1.05\u20131.29]) and major bleeding (HR, 1.32 [95% CI, 1.24\u20131.41]), whereas the use of apixaban was associated with a reduced risk of major bleeding (HR, 0.78 [95% CI, 0.67\u20130.90]) but not stroke or systemic embolism (HR, 0.84 [95% CI, 0.56\u20131.28]). Compared with rivaroxaban use, the use of apixaban was associated with a decreased risk of major bleeding (HR, 0.63 [95% CI, 0.54\u20130.73]) but not stroke or systemic embolism (HR, 0.83 [95% CI, 0.67\u20131.04]). Reanalyses with the inverse variance heterogeneity or quality effects model produced similar results as the random-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Current observational comparisons with propensity score matching methods suggest that apixaban might be a better choice compared with dabigatran or rivaroxaban for stroke prevention in atrial fibrillation patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/strokeaha.120.031007","type":"journal-article","created":{"date-parts":[[2021,2,18]],"date-time":"2021-02-18T07:58:53Z","timestamp":1613635133000},"page":"1225-1233","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":54,"title":["Comparative Effectiveness and Safety of Non\u2013Vitamin K Antagonist Oral Anticoagulants in Atrial Fibrillation Patients"],"prefix":"10.1161","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1280-0158","authenticated-orcid":true,"given":"Wengen","family":"Zhu","sequence":"first","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital (W.Z., Z.Y., S.C., D.W., J.H., Y.D., C.L.), Sun Yat-sen University, Guangzhou, PR China."},{"name":"NHC Key Laboratory of Assisted Circulation (W.Z., Z.Y., S.C., D.W., J.H., Y.D., C.L.), Sun Yat-sen University, Guangzhou, PR China."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4554-7451","authenticated-orcid":true,"given":"Zi","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The First Affiliated Hospital (W.Z., Z.Y., S.C., D.W., J.H., Y.D., C.L.), Sun Yat-sen University, Guangzhou, PR China."},{"name":"NHC Key Laboratory of Assisted Circulation (W.Z., Z.Y., S.C., D.W., J.H., Y.D., C.L.), Sun Yat-sen University, Guangzhou, PR 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