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2026, Vol: 10, Issue: 6
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Review Article
Online Published: 23 Jan 2026
 


Evaluating the effectiveness of anticoagulation therapy in atrial fibrillation: a systematic review

Mohammed Qhalib Alfaier, Khalid Alkhaldi, Seham Badawi Mohammad Mdawi, Asma Mufareh Hasan Asiri, Lama Abdullah Mohammed Almujaydil, Afnan Farhan Ayfan Alanazi, Abdulaziz Ibrahim S. Aloraini.


Abstract
Atrial fibrillation (AF) is a prevalent clinical condition associated with a heightened risk of stroke and systemic thromboembolism. In contrast to traditional vitamin K antagonists like warfarin, direct oral anticoagulants (DOACs) have demonstrated superior efficacy and safety profiles. This systematic review evaluated the comparative effectiveness of anticoagulation therapy in AF patients by analyzing 14 studies, comprising both cohort studies and randomized controlled trials conducted in the USA, Europe, and Asia. The review synthesized data on key clinical outcomes, including stroke prevention, mortality, and bleeding events, to assess the net clinical benefit of treatment. The pooled analysis found that, compared to warfarin, DOACs were associated with a significantly lower risk of ischemic stroke and major bleeding complications. Specifically, the risk of ischemic stroke or systemic embolism was substantially reduced in patients receiving anticoagulants [risk ratio (RR): 0.20, p = 0.0135). While the analysis did not reveal statistically significant differences in total mortality (RR: 0.48, p = 0.3986) or recurrent intracranial hemorrhage (RR: 0.73, p = 0.6748), the combination of warfarin and DOAC data indicated the lowest proportion of major bleeding events (0.02, p < 0.0001). These findings support the preferential use of DOACs over warfarin for stroke prevention in AF, given their association with a reduced risk of significant bleeding. Although DOACs represent a safer therapeutic option, particularly for patients at high bleeding risk, the absence of a significant mortality benefit underscores the necessity for tailored anticoagulation management. Further research is required to analyze long-term outcomes and the effects within specific patient subgroups.

Key words: Effectiveness, anticoagulation therapy, atrial fibrillation, systematic review, direct oral anticoagulants


 
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Pubmed Style

Alfaier MQ, Alkhaldi K, Mdawi SBM, Asiri AMH, Almujaydil LAM, Alanazi AFA, Aloraini AIS. Evaluating the effectiveness of anticoagulation therapy in atrial fibrillation: a systematic review. IJMDC. 2026; 10(2): 832-842. doi:10.24911/IJMDC.51-1768373225

Web Style

Alfaier MQ, Alkhaldi K, Mdawi SBM, Asiri AMH, Almujaydil LAM, Alanazi AFA, Aloraini AIS. Evaluating the effectiveness of anticoagulation therapy in atrial fibrillation: a systematic review. https://www.ijmdc.com/?mno=306757 [Access: June 27, 2026]. doi:10.24911/IJMDC.51-1768373225

AMA (American Medical Association) Style

Alfaier MQ, Alkhaldi K, Mdawi SBM, Asiri AMH, Almujaydil LAM, Alanazi AFA, Aloraini AIS. Evaluating the effectiveness of anticoagulation therapy in atrial fibrillation: a systematic review. IJMDC. 2026; 10(2): 832-842. doi:10.24911/IJMDC.51-1768373225


Vancouver/ICMJE Style

Alfaier MQ, Alkhaldi K, Mdawi SBM, Asiri AMH, Almujaydil LAM, Alanazi AFA, Aloraini AIS. Evaluating the effectiveness of anticoagulation therapy in atrial fibrillation: a systematic review. IJMDC. (2026), [cited June 27, 2026]; 10(2): 832-842. doi:10.24911/IJMDC.51-1768373225


Harvard Style

Alfaier, M. Q., Alkhaldi, . K., Mdawi, . S. B. M., Asiri, . A. M. H., Almujaydil, . L. A. M., Alanazi, . A. F. A. & Aloraini, . A. I. S. (2026) Evaluating the effectiveness of anticoagulation therapy in atrial fibrillation: a systematic review. IJMDC, 10 (2), 832-842. doi:10.24911/IJMDC.51-1768373225


Turabian Style

Alfaier, Mohammed Qhalib, Khalid Alkhaldi, Seham Badawi Mohammad Mdawi, Asma Mufareh Hasan Asiri, Lama Abdullah Mohammed Almujaydil, Afnan Farhan Ayfan Alanazi, and Abdulaziz Ibrahim S. Aloraini. 2026. Evaluating the effectiveness of anticoagulation therapy in atrial fibrillation: a systematic review. International Journal of Medicine in Developing Countries, 10 (2), 832-842. doi:10.24911/IJMDC.51-1768373225


Chicago Style

Alfaier, Mohammed Qhalib, Khalid Alkhaldi, Seham Badawi Mohammad Mdawi, Asma Mufareh Hasan Asiri, Lama Abdullah Mohammed Almujaydil, Afnan Farhan Ayfan Alanazi, and Abdulaziz Ibrahim S. Aloraini. "Evaluating the effectiveness of anticoagulation therapy in atrial fibrillation: a systematic review." International Journal of Medicine in Developing Countries 10 (2026), 832-842. doi:10.24911/IJMDC.51-1768373225


MLA (The Modern Language Association) Style

Alfaier, Mohammed Qhalib, Khalid Alkhaldi, Seham Badawi Mohammad Mdawi, Asma Mufareh Hasan Asiri, Lama Abdullah Mohammed Almujaydil, Afnan Farhan Ayfan Alanazi, and Abdulaziz Ibrahim S. Aloraini. "Evaluating the effectiveness of anticoagulation therapy in atrial fibrillation: a systematic review." International Journal of Medicine in Developing Countries 10.2 (2026), 832-842. Print. doi:10.24911/IJMDC.51-1768373225


APA (American Psychological Association) Style

Alfaier, M. Q., Alkhaldi, . K., Mdawi, . S. B. M., Asiri, . A. M. H., Almujaydil, . L. A. M., Alanazi, . A. F. A. & Aloraini, . A. I. S. (2026) Evaluating the effectiveness of anticoagulation therapy in atrial fibrillation: a systematic review. International Journal of Medicine in Developing Countries, 10 (2), 832-842. doi:10.24911/IJMDC.51-1768373225




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