Conclusion
This meta-analysis finds no differences in the rates of SSE but
increased risk of all-cause death and major bleeding between moderate
polypharmacy and severe polypharmacy versus no-polypharmacy patients. In
patients with AF and polypharmacy, NOACs showed advantages over VKAs in
SSE and any bleeding, and non-inferiority in major bleeding, ischemic
stroke, all-cause death, intracranial hemorrhage, and gastrointestinal
bleeding. In addition, all primary and secondary outcomes of NOACs and
VKAs were compared at similar rates between AF patients with and without
polypharmacy.