Association between polypharmacy and outcomes in AF patients
We synthesized the results of the included 3 post-hoc analyses RCTs
[9, 10, 28] and 2 observational studies [8, 30] reporting
outcomes in AF patients receiving oral anticoagulation with and without
polypharmacy.
As shown in Figure 2 and Supplementary Figure Ⅰ , there
were no differences in the rates of SSE between moderate polypharmacy
(HR, 1.07 [95% CI, 0.95–1.21]) and severe polypharmacy (HR, 1.14
[95% CI, 0.89–1.47]) versus no-polypharmacy patients. Moderate
polypharmacy was associated with an increased risk of all-cause death
(HR, 1.34 [95% CI, 1.25–1.44]) and major bleeding (HR, 1.23
[95% CI, 1.10–1.37]) compared with no-polypharmacy AF patients.
Risk of all-cause death (HR, 1.66 [95% CI, 1.29–2.31]) and major
bleeding (HR, 1.56 [95% CI, 1.25–1.93]) were significantly
increased in severe polypharmacy patients. In addition, the risk of
intracranial hemorrhage was not statistically different in moderate
polypharmacy (HR, 1.17 [95% CI, 0.81–1.70]), but was increased in
severe polypharmacy (HR, 1.27 [95% CI, 1.02–1.58]), compared with
non-polypharmacy patients.
Effect of NOACs versus VKAsin patients with AF and
polypharmacy