Net clinical benefit analysis of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation and chronic kidney disease: Protocol for a systematic review and meta-analysis

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From: Medicine(Vol. 98, Issue 26)
Publisher: Lippincott Williams & Wilkins, WK Health
Document Type: Author abstract; Report
Length: 271 words

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Abstract :

Byline: Nan-Nan Shen, Department of Pharmacy, Affiliated Hospital of Shaoxing University, Shao Xing, Zhejiang Province; Xue-Min Zhang, Dali Prefecture Hospital of Traditional Chinese Medicine, Da Li, Yunnan Province; Ke-Jia Le, Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai; An-Hua Wei, Department of Pharmacy, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology; Yue Wu, Department of Pharmacy, Wuhan University, Renmin Hospital, Wuhan, China.; Zhi-Chun Gu, Department of Pharmacy, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai Abstract BACKGROUND:: Atrial fibrillation (AF) is increasingly prevalent in chronic kidney disease (CKD) patients. The efficacy and safety of non-vitamin K antagonist oral anticoagulants (NOACs) in AF and CKD patients remains unknown. This systematic review and meta-analysis will mainly assess net clinical benefit (NCB) property of NOACs versus warfarin in patients with AF and CKD by a pooled-analysis. METHODS:: We will search Medline, Embase, Cochrane Library, and Clinical Website comprehensively for eligible randomized controlled trials that report the efficacy and safety outcomes according to renal function of NOACs. Relative risks and their 95% confidence intervals will be calculated using fixed- and random-effects models. Subgroup, sensitivity, and regression analyses will be performed to evaluate intertrial heterogeneity and bias of the results. NCB that balance stroke/systemic embolism (SSE) and major bleeding will be calculated using Singer's method. RESULTS:: This systemic review and meta-analysis will evaluate the NCB of NOACs versus warfarin via SSE, major bleeding and all-cause death in patients with CKD. CONCLUSIONS:: This study will provide new evidence for clinical profile of NOACs on SSE, major bleeding, all-cause death, and NCB in CKD patients. PROSPERO REGISTRATION NUMBER:: CRD42019116940.

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Gale Document Number: GALE|A591275891