Meta-Analysis of Efficacy and Safety of Apixaban in Patients Undergoing Catheter Ablation for Atrial Fibrillation

BackgroundThe efficacy and safety of apixaban in patients undergoing catheter ablation (CA) for atrial fibrillation (AF) are little investigated. MethodsThe Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, and EMBASE were searched up to September 2015. Four literatures comparing apixaban with vitamin K antagonists (VKAs) were included. Data were pooled in Review Manager Software, using Mantel-Haenszel methods with a fixed-effects model. The funnel plots and Egger's test were used to examine publication bias. Heterogeneity was assessed using the I-2 test. Risk ratios (RR) and 95% confidence intervals (CI) of each study were calculated and pooled. ResultsNo significant differences were observed in rates of total bleeding (RR = 0.91, 95% CI [0.57, 1.46], I-2 = 0.0%), thromboembolic complications (RR = 0.75, 95% CI [0.03, 18.22], I-2 = 0.0%), or total events (RR = 0.90, 95% CI [0.56, 1.44], I-2 = 0.0%) between apixaban and VKAs group. The frequency of major bleeding was similar between apixaban and VKAs group (RR = 1.34, 95% CI [0.34, 5.30], I-2 = 0.0%). ConclusionApixaban was as effective and safe as VKAs in the periprocedural period of CA.