Literature search
Two reviewers performed the literature search, systematically searching the PubMed and Embase databases sources until November 2022 for studies exploring the effect of NOACs in AF patients with polypharmacy. The following search terms were used: (1) “atrial fibrillation”, (2) “dabigatran” OR “rivaroxaban” OR “apixaban” OR “edoxaban” OR “non-vitamin K antagonist oral anticoagulant” OR “direct oral anticoagulant” OR “novel oral anticoagulant” OR “NOAC” OR “DOAC”, (3) “polypharmacy” OR “polymedication”, (4) “Vitamin K antagonists” OR “VKA” OR “warfarin” OR “dicoumarol” OR “acenocoumarol” OR “coumadin”. The above four categories of search terms were combined using the Boolean operator “and”. The detailed search strategies are shown in Supplemental Table Ⅰ . In addition, the reference lists of the retrieved articles and prior reviews were manually checked for additional eligible studies. We applied no restrictions on the language of publication.