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Comparison of two types of blood thinning drugs for preventing blood clots in people with atrial fibrillation

Bruins Slot KMH, Berge E
Published Online: 
8 August 2013

People with atrial fibrillation, a condition that causes the heart to beat irregularly, are at an increased risk of the formation of blood clots. Such clots can block blood vessels and cause severe organ damage (infarction), for example in the brain or lungs. Various guidelines recommend that patients with atrial fibrillation should be treated with blood thinning drugs that can prevent the formation of blood clots. Serious side effects of such treatment are bleedings (for example into the brain) that can cause serious disability or even death.

Until recently, the most often used blood thinning drug in people with atrial fibrillation has been warfarin, a vitamin K antagonist. Results from several studies of a new class of blood thinners, the factor Xa inhibitors, have now become available. In this review we have analysed data from 10 studies that included a total of 42,084 participants with atrial fibrillation that were either treated with warfarin or a factor Xa inhibitor. We found that the factor Xa inhibitors, when compared with warfarin, reduced the formation of blood clots in people with atrial fibrillation. Factor Xa inhibitors also appear to reduce the number of serious bleedings (including those into the brain) and number of people dying from any cause compared with warfarin.

This record should be cited as: 
Bruins Slot KMH, Berge E. Factor Xa inhibitors versus vitamin K antagonists for preventing cerebral or systemic embolism in patients with atrial fibrillation. Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No.: CD008980. DOI: 10.1002/14651858.CD008980.pub2
Assessed as up to date: 
29 April 2013