Bonanad, ClaraGarcia-Blas, SergioLlergo, Javier TorresFernandez-Olmo, RosaDiez-Villanueva, PabloAriza-Sole, AlbertMartinez-Selles, ManuelRaposeiras, SergioAyesta, AnaBertomeu-Gonzalez, VicenteTarazona Santabalbina, FranciscoFacila, LorenzoVivas, DavidGabaldon-Perez, AnaBodi, VicenteNunez, JulioCordero, Alberto2025-01-072025-01-072021-11-01https://hdl.handle.net/10668/26603Direct oral anticoagulants (DOACs) have been demonstrated to be more effective and safer than vitamin-K antagonist (VKA) for stroke prevention in patients with nonvalvular atrial fibrillation (AF). This meta-analysis aims to assess the effect of DOACS vs. VKA in patients >= 80 and AF. Primary endpoints were stroke or systemic embolism and all-cause death. Secondary endpoints included major bleeding, intracranial bleeding, and gastrointestinal bleeding. A random-effects model was selected due to significant heterogeneity. A total of 147,067 patients from 16 studies were included, 71,913 (48.90%) treated with DOACs and 75,154 with VKA (51.10%). The stroke rate was significantly lower in DOACs group compared with warfarin group (Relative risk (RR): 0.72; 95% confidence interval (CI): 0.63-0.82; p = 80 and AF. Primary endpoints were stroke or systemic embolism and all-cause death. Secondary endpoints included major bleeding, intracranial bleeding, and gastrointestinal bleeding. A random-effects model was selected due to significant heterogeneity. A total of 147,067 patients from 16 studies were included, 71,913 (48.90%) treated with DOACs and 75,154 with VKA (51.10%). The stroke rate was significantly lower in DOACs group compared with warfarin group (Relative risk (RR): 0.72; 95% confidence interval (CI): 0.63-0.82; penAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/elderlyacute coronary syndromemyocardial infarctionvitamin-K antagonistdirect oral anticoagulantsStroke preventionElderly-patientsEfficacyOlderRiskDabigatranApixabanSafetyAgeEpidemiologyreview34830548open access10.3390/jcm102252682077-0383https://www.mdpi.com/2077-0383/10/22/5268/pdf?version=1636942903757505800003