Review Article

Dabigatran, Rivaroxaban, or Apixaban versus Warfarin in Patients with Nonvalvular Atrial Fibrillation: A Systematic Review and Meta-Analysis of Subgroups

Table 3

Direct comparisons for main outcomes: absolute difference in events per 1000 patients treated per year and NNTB per year*.

Population Non-hemorrhagic stroke and SEEIntracranial bleeding
ComparisonRisk difference (95% CI)NNTB
(95% CI)
Risk difference (95% CI)NNTB
(95% CI)

All patients
All NOAC versus warfarin−1 (−2.4 to 0.5)1012 (NNTB 418 to ∞ to NNTH 2137)−3.7 (−5.3 to −3.1)271 (190 to 469)
 Dabigatran versus warfarin−1.1 (−3.6 to 1.4)934 (NNTB 280 to ∞ to NNTH 700)−4.9 (−6.5 to −3.2)206 (153 to 316)
 Rivaroxaban versus warfarin−0.9 (−4.1 to 2.2)1068 (NNTB 247 to ∞ to NNTH 458)−2.1 (−3.8 to −0.4)469 (263 to 2404)
 Apixaban versus warfarin−1.1 (−2.6 to 0.5)940 (NNTB 388 to ∞ to NNTH 1984)−4.3 (−5.9 to −2.7)232 (168 to 364)

Prior stroke or TIA
All NOAC versus warfarin−0.4 (−3.8 to 3)2404 (NNTB 263 to ∞ to NNTH 332)−5.8 (−10.9 to −2.3)173 (92 to 437)
 Dabigatran versus warfarin1.2 (−5.8 to 8.1)853 (NNTB 174 to ∞ to NNTH 123)−8.8 (−13.7 to −3.9)113 (73 to 255)
 Rivaroxaban versus warfarin−0.5 (−5.3 to 4.3)1923 (NNTB 189 to ∞ to NNTH 235)−1.7 (−4.2 to 0.7)583 (NNTB 240 to ∞ to NNTH 1479)
 Apixaban versus warfarin−1.7 (−8.9 to 5.5)595 (NNTB 112 to ∞ to NNTH 180)−8.2 (−12.9 to −3.5)121 (77 to 283)

No prior stroke or TIA
All NOAC versus warfarin−1.1 (−2.7 to 0.4)874 (NNTB 377 to ∞ to NNTH 2747)−3.3 (−4.3 to −2.3)305 (232 to 437)
 Dabigatran versus warfarin−1.6 (−4.2 to 1)613 (NNTB 236 to ∞ to NNTH 1032)−3.9 (−5.6 to −2.1)258 (178 to 478)
 Rivaroxaban versus warfarin−1.8 (−5.7 to 2)940 (NNTB 388 to ∞ to NNTH 1984)−2.6 (−4.8 to −0.3)392 (207 to 3846)
 Apixaban versus warfarin−0.7 (−3 to 1.5)1374 (NNTB 337 to ∞ to NNTH 661)−3.4 (−5 to −1.8)293 (201 to 558)

TTR ≥ 65%
All NOAC versus warfarin−0.3 (−3.0 to 2.3)3086 (NNTB 337 to ∞ to NNTH 441)−4.5 (−6.4 to −2.6)223 (156 to 384)
 Dabigatran versus warfarin1.1 (−2.1 to 4.3)NNTH 934 (NNTB 467 to ∞ to NNTH 231)−5.1 (−7.5 to −2.8)196 (134 to 363)
 Rivaroxaban versus warfarinNANA−3.4 (−6.8 to −0.1)296 (148 to 19231)
 Apixaban versus warfarin−1.6 (−4.5 to 1.4)638 (NNTB 220 to ∞ to NNTH 714)NANA

TTR < 65%
All NOAC versus warfarin−3.5 (−6.3 to −0.8)283 (159 to 1190)−2.9 (−5.7 to −0.2)344 (177 to 6536)
 Dabigatran versus warfarin−3.2 (−6.9 to 0.6)316 (NNTB 144 to ∞ to NNTH 1751)−4.4 (−6.9 to −1.9)228 (145 to 516)
 Rivaroxaban versus warfarinNANA−1.7 (−3.6 to 0.3)601 (NNTB 279 to ∞ to NNTH 3205)
 Apixaban versus warfarin−3.6 (−7.2 to 0.1)279 (NNTB 138 to ∞ to NNTH 17857)NANA

Random effects model, intention-to-treat.
NA: data not available; NNTB: number of patients needed to be treated for one additional patient to benefit; NNTH: number of patients needed to be treated for one additional patient to be harmed; NOAC: new oral anticoagulants; SEE: systemic embolic event; TIA: transient ischemic attack; TTR: time in therapeutic range.