Background: Warfarin is the standard of care and NOAC (Novel oral anticoagulants) are a group of newer drugs for\nsuch purposes. NOAC has a generally better profile (Clear interaction, less side effect, require less monitoring). However,\nits efficacy on valvular atrial fibrillation remains unclear.\nMethod: We researched literature articles from Embase, Cochrane and PubMed. Then we meta-analysed these six articles\nto assess pooled estimate of relative risk (RR) and 95% confidence intervals (Cl) using random-effects model for stroke,\nsystemic embolic event, major bleeding and all-cause mortality. Heterogeneity across study was tested with Cochranâ??s Q\nTest and I2 Test. The bias of studies was first tested by examining the symmetry of Funnel Plot. Cochraneâ??s Collaboration\nTool was also used to report any presented bias.\nResults: We collected 496 articles in total and finally we included six articles in our meta-analysis. For SSEE (Stroke, Systemic\nEmbolic Event), the pooled relative risk showed a significantly better clinical outcome of NOAC (RR: 0.66; 95% CI: 0.46 to 0.\n95). However, there is no significant difference in major bleeding (RR: 0.714, 95% CI:0.46 to 1.11) and all-cause mortality (RR:\n0.84, 95% CI: 0.58 to 1.21).\nConclusion: Compared to Warfarin, NOAC is significantly more protective against the embolic event, but no significant\ndifference in lowering risk of major bleeding, all-cause mortality or all aspects of post-TAVI (Trans-catheter aortic valve\nimplantation).
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