Systematic Review Non-Vitamin K Oral Anticoagulants in Adults with Congenital Heart Disease

Journal of Clinical Medicine
Nikolaos StalikasGeorge Giannakoulas

Abstract

Adults with congenital heart disease (ACHD) experience more thromboembolic complications than the general population. We systematically searched and critically appraised all studies on the safety and efficacy of non-vitamin-K oral anticoagulants (NOACs) in adult patients with various forms of congenital heart disease. PubMed and the Cochrane Central Register of Controlled Trials (CENTRAL) were used, with duplicate extraction of data and risk of bias assessment. The Newcastle-Ottawa quality assessment scale was used to assess study quality. Three studies fulfilled the inclusion criteria and were analyzed. The total number of participants was 766, with a total follow-up of 923 patient-years. The majority of patients (77%) received a NOAC for atrial arrhythmias, while the remainder were prescribed NOACs for secondary (19%) or primary (4%) thromboprophylaxis. The annual rate of thromboembolic and major bleeding events was low: 0.98% (95% CI: 0.51-1.86) and 1.74% (95% CI: 0.86-3.49) respectively. In Fontan patients, the annual rate of thromboembolic and major bleeding events was 3.13% (95% CI: 1.18-8.03) and 3.17% (95% CI: 0.15-41.39) respectively. NOACs appear safe and effective in ACHD without mechanical prostheses. Additional stu...Continue Reading

References

Mar 25, 2000·The Journal of Thoracic and Cardiovascular Surgery·G BallingJ Hess
Apr 13, 2001·Journal of the American College of Cardiology·C A WarnesG D Webb
May 17, 2006·Circulation·Paul KhairyUNKNOWN Epicardial Versus ENdocardial pacing and Thromboembolic events Investigators
Oct 25, 2007·Cardiology in the Young·Wendy TsangJudith Therrien
Sep 1, 2009·The New England Journal of Medicine·Stuart J ConnollyUNKNOWN RE-LY Steering Committee and Investigators
Oct 14, 2009·Circulation·Judith BouchardyAriane J Marelli
Nov 3, 2009·Journal of Thrombosis and Haemostasis : JTH·S SchulmanUNKNOWN Subcommittee on Control of Anticoagulation of the Scientific and Standardization Committee of the International Society on T
Mar 9, 2010·European Heart Journal·Carianne L VerheugtBarbara J M Mulder
Oct 21, 2010·Circulation. Cardiovascular Quality and Outcomes·Margaret C FangDaniel E Singer
Jan 5, 2011·International Journal of Cardiology·Georgios GiannakoulasTom Wong
Apr 1, 2011·Journal of Thrombosis and Haemostasis : JTH·B BrotschiM Albisetti
Jun 21, 2011·The American Journal of Cardiology·Sing-Chien YapCandice K Silversides
Aug 13, 2011·The New England Journal of Medicine·Manesh R PatelUNKNOWN ROCKET AF Investigators
Aug 30, 2011·The New England Journal of Medicine·Christopher B GrangerUNKNOWN ARISTOTLE Committees and Investigators
Oct 24, 2012·Archives of Internal Medicine·Tara GomesDavid N Juurlink
Dec 10, 2013·Hematology·Kenneth A Bauer
Jul 22, 2015·Heart·George Giannakoulas, Maria Boutsikou
Sep 1, 2015·Heart·Tarek AlsaiedGruschen R Veldtman
Aug 31, 2016·International Journal of Cardiology·Paul KhairyUNKNOWN Anticoagulation Therapy in Congenital Heart Disease (TACTIC) investigators and the Alliance for Adult Research in Congenital
Dec 3, 2016·European Respiratory Review : an Official Journal of the European Respiratory Society·Paul Clift, David Celermajer
Feb 18, 2017·International Journal of Cardiology·Keita MasudaKazutaka Aonuma
Aug 9, 2017·Cardiovascular Drugs and Therapy·Hayang YangUNKNOWN Non vitamin K antagonist Oral anticoagulants for ThromboEmbolic prevention in adult congenital heart disease (NOTE) investig
Mar 27, 2018·Congenital Heart Disease·Justin GeorgekuttyWilson W Lam
Nov 2, 2019·International Journal of Cardiology·Claudia PujolOktay Tutarel

❮ Previous
Next ❯

Citations

Sep 25, 2021·Journal of the American Heart Association·Brian W McCrindleUNKNOWN UNIVERSE Study Investigators *
Jan 14, 2022·Cardiovascular Drugs and Therapy·Amir KazerouniniaWilson W Lam

❮ Previous
Next ❯

Clinical Trials Mentioned

NCT03854149
NCT02846532
NCT02981472

Software Mentioned

Prospero
meta
R

Related Concepts

Related Feeds

Birth Defects

Birth defects encompass structural and functional alterations that occur during embryonic or fetal development and are present since birth. The cause may be genetic, environmental or unknown and can result in physical and/or mental impairment. Here is the latest research on birth defects.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.