Systematic Review And Meta Analysis Of Intracranial Hemorrhage In Patients With New Oral Anticoagulants

Objective: It is still controversial whether new oral anticoagulants(NOACs)increase the risk of intracranial hemorrhage.This article reviews the risk of intracranial hemorrhage in patients using NOACs through systematic review and meta-analysis.Method: Through the search of EMBASE,Medline,Cochrane,Pubmed,ISI Web,China Knowledge Network,VipNet and Wanfang Database,etc.,a randomized controlled trail(RCT)was included.One intervention was NOACs,and the control group was anticoagulant.,antiplatelet aggregation or placebo.The primary endpoint was intracranial hemorrhage or major bleeding.The quality of the literature was assessed using a bias risk assessment tool developed by the Cochrane Collaboration Group.Meta-analysis of the included studies was performed using Rev Man 5.3 software and Stata 12.0 software.Results: Finally,14 clinical randomized controlled trials were included with a total of 140,893 patients.Meta-analysis showed that NOACs did not increase the risk of intracranial hemorrhage compared with traditional antithrombotic drugs [OR=0.50,95% CI(0.37,0.69),P<0.01] and the risk of major bleeding[OR=0.80,95% CI(0.65,0.99),P= 0.04].Conclusion: Taking NOACs does not increase the risk of intracranial hemorrhage bleeding.