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Preventing thromboembolic events related to atrial fibrillation (AF) must be balanced with minimizing bleeding risk. In this systematic review of 6 randomized controlled trials and 111 observational studies, researchers compared the efficacy and safety of direct-acting oral anticoagulants (DOACs), warfarin, and left atrial appendage (LAA) closure devices (e.g., Watchman) for lowering thromboembolic risk in patients with AF.
Randomized trials in which ischemic stroke or systemic embolism prevention was assessed showed that apixaban (Eliquis) and dabigatran (Pradaxa) were significantly more effective than warfarin, whereas rivaroxaban (Xarelto) and edoxaban (Savaysa) had efficacy similar to warfarin's. Apixaban and edoxaban also triggered sign…