title: Myocardial infarction and atrial fibrillation: different impact of anti-IIa vs anti-Xa new oral anticoagulants: a meta-analysis of the interventional trials.
abstract: OBJECTIVE
  The aim of this study was to perform a meta-analysis, in patients with atrial fibrillation, to evaluate the impact of new oral anticoagulants (NOACs) anti-IIa and anti-Xa vs warfarin on myocardial infarction incidence.
  
  
  METHODS
  A meta-analysis of double blind randomized controlled trials (RCTs) was performed.
  
  
  RESULTS
  Four RCT studies including 84,439 patients were selected. Compared with warfarin, no significant reduction of myocardial infarction was observed with anti-Xa drugs; conversely, myocardial infarction was significantly increased with anti-IIa NOAC (1.45% vs 1.04% respectively; RR: 1.38; 95% CI, 1.1-1.7; p=0.005).
  
  
  CONCLUSIONS
  This meta-analysis suggests that in patients with atrial fibrillation, compared to standard therapy with warfarin, treatment with anti-IIa NOAC is associated with a higher incidence of myocardial infarction.
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy. Electronic address: lorenzo.loffredo@uniroma1.it.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Loffredo
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy.
authors.forename: Ludovica
authors.initials: L
authors.lastname: Perri
authors.affiliation: Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Violi
mesh_terms: D000284:Administration, Oral; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy*; D004311:Double-Blind Method; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016896:Treatment Outcome; D014859:Warfarin / Q000008:administration & dosage
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: Atrial fibrillation; Myocardial infarction; New oral anticoagulants