INTRODUCTION:

New oral anticoagulants are the latest advancement in oral anticoagulation. Several studies are published, but a few studies of synthesis information.

METHODS:

A systematic review of the studies in MEDLINE, COCHRANE and EMBASE was performed with the predefined terms. The defined inclusion and exclusion criteria were applied; variables used in this study were defined according to benefits (reduction of mortality and reduction of stroke) and anticoagulation risks (intracranial bleeding, gastrointestinal bleeding, major bleeding and other bleeding). Articles were selected and information was extracted into a spreadsheet for analysis.

RESULT:

Were included 24 meta-analyzes and 62 sub-analyzes; 77% of meta-analyzes showed stroke reduction, 65% in mortality, 71% reported decreased of intracranial hemorrhage and 45% in major bleeding, but there was an increase in gastrointestinal bleeding in 54% of the studies. Regarding the results of the sub-analysis, 4 studies for apixaban, 5 for dabigatran, 3 for edoxaban and 5 studies for rivaroxaban showed some statistically significant data. There are differences in some variables such as sex, stroke risk, 30-day results, renal function; Different doses (dabigatran and Edoxaban), according to age, gastrointestinal symptoms, relation with INR; Serum levels of the drug, use of amiodarone, prior use of warfarin; Peripheral arterial disease, transition to warfarin; Risk factors for gastrointestinal bleeding and major bleeding for each particular anticoagulant.

CONCLUSION:

The new oral anticoagulants shows better safety and efficacy profile against Warfarin.

        · resumo em Espanhol     · texto em Espanhol     · Espanhol ( pdf )