Aggregated primary and secondary outcomes across included studies.
| Study | Primary outcome(s) | Secondary outcome(s) |
|---|---|---|
| El Bèze et al. [15] | Bleeding complications (9% DOAC vs. 40% VKA) | Stroke, mortality, major vascular complications, and length of hospital stay. |
| Guerrero et al. [16] | 1 year mortality (22.4%) | Stroke (1.5%), device thrombosis (1.7%), mitral valve reintervention (9.1%), and major vascular complications (2.3%). |
| Giustino et al. [17] | Incidence of CVE (7.8% at 4 years) | Impact of anticoagulation on CVE risk (HR: 0.24 with anticoagulation, HR: 2.27 without). |
| Körber et al. [18] | MVARC-defined bleeding complications (21.6%) | Major bleeding (7.4%), transfusion requirement (4.9%), and mortality. |
| Paukovitsch et al. [19] | MVARC-defined bleeding complications (13.3%) | Major bleeding (1.7%), transfusion requirement (4.9%), and mortality. |
| Nathan et al. [20] | Trends in anticoagulant use (DOAC use increased from 12.4% in 2014 to 37.2% in 2018) | Stroke prevention, thromboembolic risk, and anticoagulant adherence. |
| Li et al. [21] | Survival and procedural success (97%) | Stroke (6.1%), mortality (6.1%), NYHA class improvement, and quality of life (KCCQ-12). |
| Geis et al. [22] | Reduction in VA and implantable cardioverter defibrillator therapies (VA reduced from 2.24 to 1.26 events/patient/month) | Mortality (21.2% at 1 year), heart failure hospitalization, and NYHA class improvement. |
| Malaisrie et al. [23] | Composite outcome of 1 year mortality and stroke (0% mortality, 0% stroke) | Quality of life (NYHA, KCCQ), valve thrombosis (6%), and valve performance. |
| Mentias et al. [14] | All-cause mortality (DOACs: HR 0.67 vs. warfarin) | Stroke (DOACs: HR 0.72 vs. warfarin), major bleeding (DOACs: HR 0.79 vs. warfarin). |
| Ludwig et al. [24] | Procedural success and mortality (100% procedural success, 6 month mortality: 22.2%) | NYHA class improvement, mitral regurgitation elimination, and major bleeding (18.2%). |
| Hohmann et al. [25] | All-cause mortality (HR: 3.84 for no anticoagulation vs. single antiplatelet therapy) | Major bleeding, ischemic stroke, and thromboembolic events. |
| Tichelbäcker et al. [26] | Left ventricular thrombus formation (1.1% overall, 4.4% in LVEF < 30%) | Stroke, mortality, and the effectiveness of the anticoagulation strategy. |
| Schipper et al. [27] | Composite of ischemic CVEs and major bleeding | Overall survival, no difference in the composite primary endpoint between DOAC and VKA; mortality was significantly lower with DOACs.Composite of ischemic events and major bleeding*. |
| Alaour et al. [28] | Net clinical benefit composite and primary safety composite (life-threatening or major bleeding) | VKAs vs. DOACs showed higher long-term mortality and lower disabling stroke with VKAs, whereas rates of major bleeding were similar.Net clinical benefit composite** and primary safety composite. |
*: Composite endpoint in Schipper et al. [27]: ischemic CVE or major bleeding (Bleeding Academic Research Consortium ≥ 3); **: net clinical benefit in Alaour et al. [28]: composite of all-cause mortality, myocardial infarction, stroke, or life-threatening/major bleeding. CVE: cerebrovascular event; DOAC: direct oral anticoagulant; HR: hazard ratio; KCCQ: Kansas City Cardiomyopathy Questionnaire; MVARC: Mitral Valve Academic Research Consortium; NYHA: New York Heart Association; VA: ventricular arrhythmias; VKA: vitamin K antagonist.