Polypharmacy and health outcomes in atrial fibrillation: a systematic review and meta-analysis

Open Heart
Celine GallagherJeroen M Hendriks

Abstract

To undertake a systematic review and meta-analysis examining the impact of polypharmacy on health outcomes in atrial fibrillation (AF). PubMed and Embase databases were searched from inception until 31 July 2019. Studies including post hoc analyses of prospective randomised controlled trials or observational design that examined the impact of polypharmacy on clinically significant outcomes in AF including mortality, hospitalisations, stroke, bleeding, falls and quality of life were eligible for inclusion. A total of six studies were identified from the systematic review, with three studies reporting on common outcomes and used for a meta-analysis. The total study population from the three studies was 33 602 and 37.2% were female. Moderate and severe polypharmacy, defined as 5-9 medicines and >9 medicines, was observed in 42.7% and 20.7% of patients respectively, and was associated with a significant increase in all-cause mortality (Hazard ratio [HR] 1.36, 95% CI 1.20 to 1.54, p<0.001; HR 1.84, 95% CI 1.40 to 2.41, p<0.001, respectively), major bleeding (HR 1.32, 95% CI 1.14 to 1.52, p<0.001; HR 1.68, 95% CI 1.35 to 2.09, p<0.001, respectively) and clinically relevant non-major bleeding (HR 1.12, 95% CI 1.03 to 1.22, p<0.01; HR ...Continue Reading

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Citations

Oct 29, 2020·Nature Reviews. Cardiology·Agnieszka KotalczykGregory Y H Lip
Mar 12, 2021·European Geriatric Medicine·Farhad Pazan, Martin Wehling
Aug 12, 2021·Journal of Comparative Effectiveness Research·François LalibertéJeffrey S Berger
Nov 4, 2021·Journal of Bone and Mineral Metabolism·Minako WakasugiIchiei Narita

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Methods Mentioned

BETA
pharmacotherapy

Software Mentioned

Review Manager ( RevMan )
Quality in Prognosis Studies

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