Background: Anticoagulation in patients with pulmonary embolism.
Objective: To identify how non-vitamin K antagonist oral anticoagulants are associated with multiple outcomes in
patients with pulmonary embolism.
Methods: We performed a systematic search of systematic reviews via multiple electronic databases from inception
to August 19th, 2019, without language restriction. Two authors independently extracted data and assessed
the methodological quality of the included systematic reviews using the ROBIS tool.
Results: We found twelve systematic reviews. Eleven SRs collected their data from randomized clinical trials and
one from observational studies. All the included studies were published between 2014 and 2019 in English. The
methodological quality of the 12 systematic reviews was low to high. None of the systematic reviews, which are
included in our overview of systematic reviews, has evaluated the overall quality of evidence outcome using the
Grading of Recommendations Assessments, Development and Evaluation (GRADE) approach.
Conclusion: This is the first effort to summarize evidence about non-vitamin K antagonist oral anticoagulants in
an overview of systematic reviews focusing exclusively on patients with pulmonary embolism. The evidence
suggests that the non-vitamin K antagonist oral anticoagulants seem to be more effective and safer than a dualdrug
approach with LMWH- VKA.