Meta-Analysis of Efficacy and Safety of Apixaban in Patients Undergoing Catheter Ablation for Atrial Fibrillation

Pacing Clin Electrophysiol. 2016 Jan;39(1):54-9. doi: 10.1111/pace.12771. Epub 2015 Nov 27.

Abstract

Background: The efficacy and safety of apixaban in patients undergoing catheter ablation (CA) for atrial fibrillation (AF) are little investigated.

Methods: The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE were searched up to September 2015. Four literatures comparing apixaban with vitamin K antagonists (VKAs) were included. Data were pooled in Review Manager Software, using Mantel-Haenszel methods with a fixed-effects model. The funnel plots and Egger's test were used to examine publication bias. Heterogeneity was assessed using the I(2) test. Risk ratios (RR) and 95% confidence intervals (CI) of each study were calculated and pooled.

Results: No significant differences were observed in rates of total bleeding (RR = 0.91, 95% CI [0.57, 1.46], I(2) = 0.0%), thromboembolic complications (RR = 0.75, 95% CI [0.03, 18.22], I(2) = 0.0%), or total events (RR = 0.90, 95% CI [0.56, 1.44], I(2) = 0.0%) between apixaban and VKAs group. The frequency of major bleeding was similar between apixaban and VKAs group (RR = 1.34, 95% CI [0.34, 5.30], I(2) = 0.0%).

Conclusion: Apixaban was as effective and safe as VKAs in the periprocedural period of CA.

Keywords: anticoagulation; apixaban; atrial fibrillation; catheter ablation.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Aged
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / epidemiology*
  • Atrial Fibrillation / surgery*
  • Catheter Ablation / statistics & numerical data*
  • Causality
  • Comorbidity
  • Female
  • Fibrinolytic Agents / administration & dosage
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Postoperative Hemorrhage / diagnosis
  • Postoperative Hemorrhage / epidemiology*
  • Pyrazoles / administration & dosage*
  • Pyridones / administration & dosage*
  • Risk Factors
  • Thromboembolism / diagnosis
  • Thromboembolism / epidemiology
  • Thromboembolism / prevention & control*
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Pyrazoles
  • Pyridones
  • apixaban