Table 1 Characteristics of included studies

Youssef [8] 2023

Africa

RCT

50

DOACs:

52 ± 8.2

VKAs:

53 ± 7.9

N/A

DOACs:

44.0

VKAs:

40.0

N/A

N/A

25

warfarin

A

DOACs:

2.86 ± 0.96 × 1.54 ± 0.71

VKAs:

2.56 ± 1.15 × 1.59 ± 0.64

DOACs:

26.4

VKAs:

27.3

6 mths

TTE

73%

DOACs:

Single (16.0)

DAPT (80.0)

VKAs:

Single (20.0)

DAPT (80.0)

Seiler [11] 2023

Europe

retrospective cohort study

101

DOACs:

64.3 ± 12.1

VKAs:

62.2 ± 14.2

DOACs:

87.5

VKAs:

77.4

DOACs:

54.2

VKAs:

47.1

DOACs:

87.5

VKAs:

90.6

DOACs:

4.2

VKAs:

0

48

Phenprocoumon

A = 17

R = 31

DOACs:

2.09 (1.05, 3.71)

VKAs:

2.31 (1.6, 5.7)

DOACs:

40 ± 14

VKAs:

34 ± 11

median

26.6 mths

TTE

N/A

DOACs:

Aspirin (37.5)

Ticagrelor (4.2)

Clopidogrel (41.7)

Prasugrel (2.1)

VKAs:

Aspirin (50.9)

Ticagrelor (3.8)

Clopidogrel (36.0)

Prasugrel (3.8)

Yang [9] 2023

Asia

retrospective registry study

124

50.2 ± 14.6

87.9

N/A

47.6

33.1

91

warfarin

N/A

2.2 (1.5, 3.2) × 1.2 (0.9, 1.7)

30 (22, 40)

> 3 mths

TTE, CMR

N/A

41.9

Single (25.0)

DAPT (16.9)

Tamimi [12] 2022

USA

retrospective cohort study

191

mean 64.0

77.0

N/A

66.4

N/A

48

warfarin

A, E, R

N/A

N/A

N/A

echocardiography

N/A

N/A

Herald [13] 2022

USA

retrospective cohort study

433

DOACs:

66 (57, 75)

VKAs:

65 (55, 73)

DOACs:

86.6

VKAs:

80.9

N/A

N/A

N/A

134

warfarin

A = 20

D = 108

R = 6

N/A

N/A

3.4 yrs (1.9–5.9)

TTE

N/A

DOACs:

44.8

VKAs:

37.8

Alcalai [14] 2022

Asia

RCT

35

DOACs:

55.5 ± 12.9

VKAs:

58.8 ± 10.2

DOACs:

72.2

VKAs:

88.2

100.0

DOACs:

22.2

VKAs:

17.7

N/A

18

warfarin

A

DOACs:

1.99 ± 0.94 × 1.24 ± 0.58

VKAs:

1.85 ± 0.69 × 1.23 ± 0.40

DOACs:

35.0 ± 5.0

VKAs:

36.0 ± 7.0

3 mths

TTE

N/A

DAPT (100.0)

Zhang [20] 2022

Asia

retrospective cohort study

64

DOACs:

60.3 ± 14.7

VKAs:

61.3 ± 9.0

DOACs:

72.7

VKAs:

74.2

100.0

N/A

N/A

33

warfarin

R

N/A

DOACs:

42.9 ± 13.1

VKAs:

41.4 ± 10.8

median 25.0 mths

TTE

N/A

DAPT (100.0)

Abdelnabi [35] 2021

Africa

RCT

79

49.6 ± 12.5

57

N/A

78.5

N/A

39

warfarin

R

1.61 ± 0.438 × 1.15 ± 0.264

36.6

6 mths

TTE

N/A

DAPT (53.1)

Albabtain [15] 2021

Asia

retrospective cohort study

63

DOACs:

58.25 (17.73)

VKAs:

59 (15.62)

DOACs:

85.71

VKAs:

97.14

DOACs:

57.14

VKAs:

71.43

N/A

N/A

28

warfarin

R

DOACs:

1.75 (0.7–3.49)

VKAs:

1.77 (0.66–2.21)

DOACs:

26.43 (8.15)

VKAs:

27.29 (7.8)

DOACs:

9.5 (6–32.5)

mths

VKAs:

14(3–41) mths

TTE

N/A

DOACs:

Aspirin (67.86)

Clopidogrel (46.43)

VKAs:

Aspirin (57.14)

Clopidogrel (60.0)

Mihm [17] 2021

USA

retrospective cohort study

108

DOACs:

63.3 (14.4)

VKAs:

60.3 (13.9)

DOACs:

69.7

VKAs:

72.0

DOACs:

15.2

VKAs:

14.7

N/A

N/A

33

warfarin

A = 23

R = 10

N/A

DOACs:

32.58 (16.4)

VKAs:

27.95 (12.6)

6 mths

TTE, CMR

N/A

DOACs:

Aspirin (57.6)

P2Y12i (21.2)

VKAs:

Aspirin (73.3)

P2Y12i (25.3)

Xu [18] 2021

Asia

retrospective cohort study

87

DOACs:

59.4 ± 11.5

VKAs:

61.9 ± 12.2

DOACs:

76.0

VKAs:

75.8

DOACs:

16.0

VKAs:

21.0

DOACs:

72.0

VKAs:

77.4

N/A

25

warfarin

D = 9

R = 16

N/A

DOACs:

33.8 ± 5.7

VKAs:

37.6 ± 6.6

2.37 ± 2.1 yrs

TTE

N/A

DOACs:

44.0

VKAs:

43.5

Varwani [19] 2021

Africa

retrospective cohort study

100

mean 60.9

77.0

28.0

42.0

N/A

58

warfarin

A = 5

D = 7

R = 46

N/A

28.5 ± 11.0

N/A

TTE

N/A

N/A

Bass [21] 2021

USA

retrospective cohort study

949

DOACs:

63.4 ± 16.7

VKAs:

61.6 ± 15.3

DOACs:

69.4

VKAs:

70.9

DOACs:

42.8

VKAs:

57.6

N/A

N/A

180

warfarin

A = 79

R = 77

D = 29

N/A

N/A

3 mths

N/A

N/A

DOACs:

46.7

VKAs:

55.7

Cochran [27] 2021

USA

retrospective cohort study

73

DOACs:

51.5 (39.0–73.0)

VKAs:

62.0 (34.0–84.0)

DOACs:

78.6

VKAs:

76.3

DOACs:

43.0

VKAs:

49.0

N/A

N/A

14

warfarin

A, E, D, R

N/A

N/A

12 mths

TTE

N/A

N/A

Jones [23] 2021

Europe

prospective cohort study

101

DOACs:

58.73 ± 14.2

VKAs:

60.81 ± 14.3

DOACs:

80.4

VKAs:

85.0

100.0

N/A

N/A

41

warfarin

A = 15

E = 2

R = 24

N/A

DOACs:

33.5 ± 10.0

VKAs:

35.4 ± 9.0

median 2.2 yrs

TTE, CMR

53.3%

DOACs:

92.7

Single (24.4)

DAPT (68.3)

VKAs:

91.7

Single (21.7)

DAPT (70.0)

Willeford [25] 2021

USA

retrospective cohort study

151

DOACs:

54 (48–64)

VKAs:

56 (49–65.5)

DOACs:

77.3

VKAs:

80.6

DOACs:

22.7

VKAs:

26.4

N/A

N/A

22

warfarin

A = 4

R = 18

N/A

N/A

median:

254 days

echocardiography

N/A

56.3

Single (37.1)

DAPT (19.2)

Minciunescu [22] 2020

USA

retrospective cohort study

212

DOACs:

60.4 ± 15.9

VKAs:

59.5 ± 13.9

DOACs:

80.7

VKAs:

75.5

N/A

N/A

N/A

57

warfarin

N/A

N/A

N/A

N/A

N/A

N/A

74.5

Iqbal [24] 2020

Europe

retrospective cohort study

84

DOACs:

62 ± 13

VKAs:

62 ± 14

DOACs:

91.0

VKAs: 89.0

N/A

DOACs:

82.0

VKAs:

89.0

DOACs:

9.0

VKAs:

3.0

22

warfarin

A = 8

D = 1

R = 13

N/A

DOACs:

31 ± 13

VKAs:

35 ± 13

3.0 ± 1.4 yrs

TTE, TEE, CMR

N/A

65.0

Single (27.0)

DAPT (38.0)

Yunis [26] 2020

USA

retrospective cohort study

264

N/A

N/A

N/A

N/A

N/A

64

warfarin

N/A

N/A

N/A

24 mths

TTE, TEE

N/A

N/A

Isa [16] 2020

Asia

RCT

27

DOACs:

55.36 (11.04)

VKAs:

55.00 (11.42)

DOACs:

92.9

VKAs:

92.3

N/A

DOACs:

64.3

VKAs:

61.5

N/A

14

warfarin

A

DOACs:

1.98 (0.41–3.55)

VKAs:

0.95 (0.17–1.73)

33.5 ± 5.73

3 mths

TTE

N/A

N/A

Ali [30] 2020

USA

retrospective cohort study

92

DOACs:

59.2 ± 11.9

VKAs:

58.0 ± 16.3

DOACs:

81.3

VKAs:

81.7

N/A

N/A

N/A

32

warfarin

A = 13

R = 18

D = 1

N/A

DOACs:

23.0 ± 9.4

VKAs:

23.2 ± 11.2

 > 1yr

in 58.2%

TTE, CMR

N/A

Aspirin: 65.45Clopidogrel: 14.55Ticagrelor: 0.91Prasugrel: 1.82

Robinson [28] 2020

USA

retrospective cohort study

514

DOACs:

58.1 (14.9)

VKAs:

58.2 (15.1)

DOACs:

77.7

VKAs:

72.0

N/A

DOACs:

54.5

VKAs:

62.7

N/A

121

warfarin

N/A

DOACs:

2.8 (2.1)

VKAs:

2.8 (2.5)

DOACs:

27.7 (13.8)

VKAs:

28.2 (12.4)

351 days

(51–866)

TTE

N/A

DOACs:

63.6

VKAs:

69.5

Guddeti [29] 2020

USA

retrospective cohort study

99

DOACs:

60.7 ± 13.1

VKAs:

61.3 ± 12.2

DOACs:

79.0

VKAs:

68.8

DOACs:

21.0

VKAs:

20.5

DOACs:

52.6

VKAs:

60

N/A

19

warfarin

A = 15

R = 2

D = 2

N/A

DOACs:

25(20–40)

VKAs:

25(20–35)

10.4 ± 3.4 mths

echocardiography

N/A

DOACs:

Aspirin (57.9)

P2Y12i (15.8)

VKAs:

Aspirin (67.5)

P2Y12i (15.0)

Daher [31] 2020

Europe

retrospective cohort study

59

DOACs:

57.0 ± 14.0

VKAs:

61.0 ± 13.0

DOACs:

82.4

VKAs:

83.0

N/A

DOACs:

88.0

VKAs:

74.0

13.5

17

warfarin, acenocoumarol, fluindione

A = 12

R = 4

D = 1

N/A

DOACs:

41.0 ± 8.0

VKAs:

36.0 ± 12.0

 N/A

TTE

N/A

DOACs:

Aspirin (58.8)

P2Y12i (64.7)

VKAs:

Aspirin (66.7)

P2Y12i (40.5)

Lim [34] 2019

Asia

retrospective cohort study

23

55 ± 9.6

73.9

N/A

87.0

N/A

5

warfarin

D = 3

R = 2

N/A

30.8 ± 10.6

N/A

echocardiography

N/A

N/A

Gama [32] 2019

Europe

retrospective cohort study

66

69 ± 12

77.3

N/A

N/A

N/A

13

warfarin

N/A

N/A

N/A

N/A

echocardiography, CMR

N/A

N/A

Jaidka [33] 2018

Europe

retrospective cohort study

49

DOACs:

57.2 ± 9.3

VKAs:

61.3 ± 12.1

DOACs:

75.0

VKAs:

75.7

100.0

N/A

N/A

12

warfarin

N/A

N/A

DOACs:

36.7 ± 10.1

VKAs:

20.0 ± 20.7

6 mths

TTE

N/A

DOACs:Aspirin (75)

Clopidogrel (100.0)

Ticagrelor (0.0)

VKAs:Aspirin (89.9)

Clopidogrel (89.9)

Ticagrelor (8.1)