PDF(Pubmed)
Abstract：
UNASSIGNED: This study aimed to compare the efficacy of novel oral anticoagulants (NOACs) with traditional anticoagulants vitamin K antagonists (VKAs) in patients with atrial fibrillation (AF) post transcatheter aortic valve replacement (TAVR).
UNASSIGNED: Studies comparing the usage of NOACs and VKAs in AF patients with oral anticoagulant indication post-TAVR were retrieved from PubMed, EMBASE, Medline, and Cochrane databases from their building-up to Jan. 2023. The literature was screened in line of inclusion and exclusion criteria. Risk ratio (RR) or odds ratio (OR),95% confidence interval (CI) and number needed to treat (NNT) were calculated for four main indexes that composite endpoints composed mainly of any clinically relevant risk events, stroke, major bleeding, and all-cause mortality. Subsequently, a meta-analysis was performed using the RevMan5.3 and Stata 16.0 software.
UNASSIGNED: In the aggregate of thirteen studies, contained 30388 post-TAVR patients with AF, were included in this meta-analysis. Our results indicated that there was no significant difference in stroke between the NOACs group and the VKAs group, and the NOACs group had a numerically but non-significantly higher number of composite endpoint events compared with the other group. Nevertheless, the incidence of major bleeding [11.29% vs. 13.89%, RR 0.82, 95%CI (0.77,0.88), P < 0.00001, I² = 69%, NNT = 38] and all-cause mortality [14.18% vs. 17.61%, RR 0.83, 95%CI (0.79,0.88), p < 0.00001, I² = 82%, NNT = 29] were significantly lower in the NOACs group than another group.
UNASSIGNED: Taken together, our data indicated that the usage of NOACs reduced the incidence of major bleeding and all-cause mortality compared to VKAs in post-TAVR patients with AF.
UNASSIGNED: Studies comparing the usage of NOACs and VKAs in AF patients with oral anticoagulant indication post-TAVR were retrieved from PubMed, EMBASE, Medline, and Cochrane databases from their building-up to Jan. 2023. The literature was screened in line of inclusion and exclusion criteria. Risk ratio (RR) or odds ratio (OR),95% confidence interval (CI) and number needed to treat (NNT) were calculated for four main indexes that composite endpoints composed mainly of any clinically relevant risk events, stroke, major bleeding, and all-cause mortality. Subsequently, a meta-analysis was performed using the RevMan5.3 and Stata 16.0 software.
UNASSIGNED: In the aggregate of thirteen studies, contained 30388 post-TAVR patients with AF, were included in this meta-analysis. Our results indicated that there was no significant difference in stroke between the NOACs group and the VKAs group, and the NOACs group had a numerically but non-significantly higher number of composite endpoint events compared with the other group. Nevertheless, the incidence of major bleeding [11.29% vs. 13.89%, RR 0.82, 95%CI (0.77,0.88), P < 0.00001, I² = 69%, NNT = 38] and all-cause mortality [14.18% vs. 17.61%, RR 0.83, 95%CI (0.79,0.88), p < 0.00001, I² = 82%, NNT = 29] were significantly lower in the NOACs group than another group.
UNASSIGNED: Taken together, our data indicated that the usage of NOACs reduced the incidence of major bleeding and all-cause mortality compared to VKAs in post-TAVR patients with AF.
摘要：
■本研究旨在比较新型口服抗凝剂（NOAC）与传统抗凝剂维生素K拮抗剂（VKAs）在经导管主动脉瓣置换术（TAVR）后房颤（AF）患者中的疗效。
比较TAVR后口服抗凝适应症的房颤患者NOAC和VKAs使用情况的研究从PubMed检索，EMBASE,Medline,从建立到1月的Cochrane数据库2023年。根据纳入和排除标准筛选文献。风险比(RR)或赔率比(OR)，计算4个主要指标的95%置信区间(CI)和需要治疗的数量(NNT),即复合终点主要由任何临床相关风险事件组成,中风,大出血,和全因死亡率。随后，使用RevMan5.3和Stata16.0软件进行荟萃分析.
■在13项研究的总和中，包含30388名TAVR后房颤患者，纳入本荟萃分析。我们的结果表明，NOAC组和VKAs组之间的卒中没有显着差异，与其他组相比,NOACs组的复合终点事件数量在数值上较高,但非显著较高.然而，大出血的发生率[11.29%vs.13.89%,RR0.82，95CI（0.77,0.88），P<0.00001,I²=69%,NNT=38]和全因死亡率[14.18%vs.17.61%,RR0.83，95CI（0.79,0.88），p<0.00001,I²=82%,NNT=29]在NOACs组中显著低于另一组。
■放在一起，我们的数据表明,在TAVR术后AF患者中,与VKAs相比,NOAC的使用降低了大出血的发生率和全因死亡率.
比较TAVR后口服抗凝适应症的房颤患者NOAC和VKAs使用情况的研究从PubMed检索，EMBASE,Medline,从建立到1月的Cochrane数据库2023年。根据纳入和排除标准筛选文献。风险比(RR)或赔率比(OR)，计算4个主要指标的95%置信区间(CI)和需要治疗的数量(NNT),即复合终点主要由任何临床相关风险事件组成,中风,大出血,和全因死亡率。随后，使用RevMan5.3和Stata16.0软件进行荟萃分析.
■在13项研究的总和中，包含30388名TAVR后房颤患者，纳入本荟萃分析。我们的结果表明，NOAC组和VKAs组之间的卒中没有显着差异，与其他组相比,NOACs组的复合终点事件数量在数值上较高,但非显著较高.然而，大出血的发生率[11.29%vs.13.89%,RR0.82，95CI（0.77,0.88），P<0.00001,I²=69%,NNT=38]和全因死亡率[14.18%vs.17.61%,RR0.83，95CI（0.79,0.88），p<0.00001,I²=82%,NNT=29]在NOACs组中显著低于另一组。
■放在一起，我们的数据表明,在TAVR术后AF患者中,与VKAs相比,NOAC的使用降低了大出血的发生率和全因死亡率.
