Table 1 Detailed characteristics of included studies
Study | Country | Strategy | Source of participants | Population | Anticoagulation regimen | Endpoints | Follow-up time (years) | The Newcastle–Ottawa score | |
|---|---|---|---|---|---|---|---|---|---|
Efficacy endpoints | Safety endpoints | ||||||||
Noseworthy 2016 [15] | America | Retrospective, observational study | United States commercial insurance database (OptumLabs Data Warehouse), 2010–2015 | HCM and AF (n = 2198) | DOACs (n = 579) vs. Warfarin (n = 1619) After propensity score matching: DOACs (n = 568) (Dabigatran 41.4%, Rivaroxaban 40.6%, Apixaban 18%) vs. Warfarin (n = 859) | Stroke or systemic embolism, ischemic stroke | Major bleeding, gastrointestinal bleeding, intracranial hemorrhage | 0.56 | 7 |
Dominguez 2017 [16] | Spain | Retrospective, multicentre, longitudinal cohort study | Nine Spanish Inherited Cardiac Disease Units, 2011–2016 | HCM and nonvalvular AF (n = 532) | DOACs (n = 99) (rivaroxaban 47.5%, dabigatran 29.3%, apixaban 23.2%) vs. VKAs (acenocoumarol) (n = 433) | Thromboembolic event (cerebrovascular accident + transient ischemic attack + peripheral embolism), death | Major or clinically relevant bleeding, gastrointestinal bleeding, intracranial hemorrhage | 5.25 (2.17–9.08) | 6 |
Jung 2019 [17] | Korea | Retrospective, observational study | Korean National Health Insurance Service database, 2011–2016 | HCM and AF (n = 3490) | DOACs (n = 2302) (Rivaroxaban 39%, Dabigatran 31%, Apixaban 25%, Edoxaban 5.3%) vs. Warfarin (n = 1188) After propensity score matching: DOACs (n = 1504) vs. Warfarin (n = 955) The CHA2DS2-VASc score: Warfarin: 4.67 ± 2.08 DOACs: 4.82 ± 1.84 | All-cause mortality, composite of fatal cardiovascular events, ischemic stroke or systemic embolism | Major bleeding, gastrointestinal bleeding, intracranial hemorrhage | 1.33 ± 1.33 | 8 |
Lee 2019 [18] | Korea | Retrospective, observational study | Korean Health Insurance Review and Assessment Service database, 2013–2016 | HCM and nonvalvular AF (n = 2397) | DOACs (n = 1405) (Rivaroxaban 8%, Dabigatran 22%, Apixaban 27%, Edoxaban14%) vs. Warfarin (n = 992) (Inverse probability of treatment weighting with propensity scores) The CHA2DS2-VASc score: Warfarin: 3.8 ± 1.9 DOAC: 3.7 ± 1.7 | Ischemic stroke, all-cause death, composite outcome (ischemic stroke + all-cause death + intracranial hemorrhage + hospitalization for gastrointestinal bleeding) | Major bleeding, gastrointestinal bleeding, intracranial hemorrhage | 1.60 ± 1.40 | 8 |
Park 2019 [21] | Korea | Retrospective, observational study | Samsung Medical Center, Seoul, South Korea | HCM and AF (n = 261) | DOACs (n = 158) vs. VKAs (n = 103) | Thromboembolic event (transient ischemic attack/stroke + peripheral embolism) | Major or clinically relevant bleeding | 1.93 | 6 |
Lin 2022 [19] | China | Retrospective, single-center, observational study | The First Affiliated Hospital of Fujian Medical University, China, 2015–2019 | HCM and AF (n = 124) | DOACs (n = 76) (rivaroxaban 55.3%, dabigatran 44.7%) vs. Warfarin (n = 48) The CHA2DS2-VASc score: Warfarin: 2 (2, 5) NOAC: 3 (2, 4) | All-cause death, cardiovascular death, thromboembolic events (ischemic stroke + TIA + left atrial thrombosis + peripheral embolism) | Clinically relevant bleeding, gastrointestinal bleeding, intracranial hemorrhage | 4.47 ± 0.17 | 7 |
Liu 2022 [20] | China | Prospective, multi-center, cohort study | The Chinese Atrial Fibrillation Registry Study, 2011–2018 | HCM and AF (n = 393) | DOACs (n = 133) vs. Warfarin (n = 260) | Thromboembolism (non-fatal ischemic stroke + peripheral embolism) | Major bleeding | 3.5 (2–5) | 8 |