UNASSIGNED: We performed systematic research from the PubMed, EMBASE, and Cochrane Library databases until November 2022 to obtain relevant observational studies. Adjusted risk ratios (RRs) and 95 % confidence intervals (CIs) of the outcomes were collected and pooled by a random-effects model. This study was prospectively registered in PROSPERO (CRD42022314222).
UNASSIGNED: A total of 17 observational studies were included in this meta-analysis. Compared with vitamin K antagonists, edoxaban was associated with lower risks of stroke or systemic embolism (RR = 0.67, 95 % CI:0.61-0.74), major bleeding (RR = 0.54, 95 % CI:0.44-0.67), and intracranial hemorrhage (RR = 0.51, 95 % CI:0.29-0.90). Compared with dabigatran or rivaroxaban, edoxaban was associated with reduced risks of stroke or systemic embolism (dabigatran [RR = 0.76, 95 % CI:0.66-0.87]; rivaroxaban [RR = 0.81, 95 % CI:0.70-0.94]) and major bleeding (dabigatran [RR = 0.82, 95 % CI:0.69-0.98]; rivaroxaban [RR = 0.81, 95 % CI:0.70-0.94]). Compared with apixaban, edoxaban was associated with a reduced risk of stroke or systemic embolism (RR = 0.87, 95 % CI:0.79-0.97), but had similar risks of bleeding events.
UNASSIGNED: Our current evidence suggested that edoxaban might have superior effectiveness and/or safety outcomes than vitamin K antagonists, dabigatran, rivaroxaban, and apixaban for stroke prevention in patients with AF.
■我们从PubMed进行了系统研究,EMBASE,和Cochrane图书馆数据库,直到2022年11月才能获得相关的观察性研究。通过随机效应模型收集并汇总结果的调整风险比(RR)和95%置信区间(CI)。本研究在PROSPERO(CRD42022314222)中进行了前瞻性注册。
■本荟萃分析共纳入17项观察性研究。与维生素K拮抗剂相比,依度沙班与卒中或全身性栓塞的风险较低相关(RR=0.67,95%CI:0.61-0.74),大出血(RR=0.54,95%CI:0.44-0.67),和颅内出血(RR=0.51,95%CI:0.29-0.90)。与达比加群或利伐沙班相比,依度沙班与卒中或全身性栓塞风险降低相关(达比加群[RR=0.76,95%CI:0.66-0.87];利伐沙班[RR=0.81,95%CI:0.70-0.94])和大出血(达比加群[RR=0.82,95%CI:0.69-0.98];利伐沙班[RR=0.81-94%]:0.70.与阿哌沙班相比,依度沙班与卒中或全身性栓塞的风险降低相关(RR=0.87,95%CI:0.79-0.97),但有类似的出血事件风险.
■我们目前的证据表明,依度沙班可能比维生素K拮抗剂具有更好的有效性和/或安全性结果,达比加群,利伐沙班,和阿哌沙班用于预防房颤患者的卒中。