The new oral anticoagulants are at least as good as, if not better than, warfarin at preventing strokes in patients with atrial fibrillation and have a lower rate of major bleeding, a large meta-analysis has found. The analysis, published in The Lancet, covered trials of atrial fibrillation patients who were randomised to new oral anticoagulants or warfarin, and in which both efficacy and safety outcomes were reported. A total of 71,683 patients in the RE-LY, ROCKET AF, ARISTOTLE, and ENGAGE AF-TIMI 48 trials were included.