Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants After Cardioversion for Nonvalvular Atrial Fibrillation Giulia Renda, MD, PhD, Marco.

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Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants After Cardioversion for Nonvalvular Atrial Fibrillation Giulia Renda, MD, PhD, Marco Zimarino, MD, PhD, Fabrizio Ricci, MD, Jonathan P. Piccini, MD, Michael D. Ezekowitz, MD, PhD, Manesh R. Patel, MD, PhD, Riccardo Cappato, MD, Robert P. Giugliano, MD, Raffaele De Caterina, MD, PhD The American Journal of Medicine Volume 129, Issue 10, Pages 1117-1123.e2 (October 2016) DOI: 10.1016/j.amjmed.2016.05.007 Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 1 Flow chart showing the process of study selection. RCTs = randomized, controlled trials. The American Journal of Medicine 2016 129, 1117-1123.e2DOI: (10.1016/j.amjmed.2016.05.007) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 2 Outcome comparison between non-vitamin K oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) in patients with atrial fibrillation undergoing cardioversion. Forest plot with individual and summary estimates of the risk ratio and 95% confidence interval (CI) of stroke/systemic embolism. A random-effects model was applied to estimate risk ratio and 95% CI. Squares and diamond sizes are proportional to study weight. The American Journal of Medicine 2016 129, 1117-1123.e2DOI: (10.1016/j.amjmed.2016.05.007) Copyright © 2016 Elsevier Inc. Terms and Conditions

Figure 3 Outcome comparison between non-vitamin K oral anticoagulants (NOACs) and vitamin K antagonists (VKAs) in patients with atrial fibrillation undergoing cardioversion. Forest plot with individual and summary estimates of the risk ratio and 95% confidence interval (CI) of major bleeding. A random-effect model was applied to estimate risk ratio and 95% CI. Squares and diamond sizes are proportional to study weight. The American Journal of Medicine 2016 129, 1117-1123.e2DOI: (10.1016/j.amjmed.2016.05.007) Copyright © 2016 Elsevier Inc. Terms and Conditions

Supplementary Figure 1 Assessment of publication bias. Begg's funnel plot of studies according to the risk ratio (RR) of stroke/systemic embolism (A) and major bleeding (B) vs the standard error of risk ratio. The American Journal of Medicine 2016 129, 1117-1123.e2DOI: (10.1016/j.amjmed.2016.05.007) Copyright © 2016 Elsevier Inc. Terms and Conditions

Supplementary Figure 2 Jackknife sensitivity analysis. To evaluate whether the summary estimate of the effect could have been significantly affected by a single study, pooled estimates for stroke/systemic embolism (A) and major bleeding (B) were recalculated, using a random-effects model, by omitting one study at a time. Each line represents a reanalysis of the data with exclusion of one study at a time to assess the influence of this particular study on the overall result. The American Journal of Medicine 2016 129, 1117-1123.e2DOI: (10.1016/j.amjmed.2016.05.007) Copyright © 2016 Elsevier Inc. Terms and Conditions