PDF(Pubmed)
Abstract：
An effective anticoagulation therapy is required for patients with atrial fibrillation because it presents a significant risk of stroke. The current study evaluates the relative safety as well as efficacy of rivaroxaban in patients who are diagnosed with atrial fibrillation. A thorough literature review of relevant databases was conducted, focusing on academic and clinical studies that were published from 2017 onward. Inclusion criteria comprised randomized controlled trials and other observational studies comparing the incidence of stroke and the safety index of rivaroxaban in atrial fibrillation. We followed the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) for data overview reporting and overview. A total of 21 studies were selected based on the inclusion criteria. A total of 19/21 studies advocated the adoption of rivaroxaban for minimizing stroke incidence. Rivaroxaban also showed superiority in achieving the therapeutic objectives, i.e., reduction in the incidence of stroke. The results for rivaroxaban against warfarin showed an improved safety index and effectiveness of rivaroxaban. The total effect size for the analysis was calculated to be Z=2.62 (p-value=0.009). The individual effect of all studies favored the \"rivaroxaban\" group. The heterogeneity in the study was as follows: tau2=0.10; chi2=110.10, df=6; I2=95%. The second analysis for risk reduction and incidence of stroke after rivaroxaban therapy also showed a bias towards rivaroxaban therapy. The combined effect for the analysis was found to be as follows: HR=0.73 ((95% CI: 0.50, 1.07). The total effect was calculated to be Z=1.61 (p-value= 0.10). The heterogeneity was found to be as follows: tau2= 0.20, chi2=89.97, df=6, I2=93%. Standard dosing of rivaroxaban emerges as a preferred strategy for stroke prevention, balancing efficacy and safety. Clinical decision-making should consider individual patient characteristics and future research should delve into specific subpopulations and long-term outcomes to further refine treatment guidelines.
摘要：
房颤患者需要有效的抗凝治疗，因为它存在明显的中风风险。本研究评估了利伐沙班在诊断为房颤患者中的相对安全性和有效性。对相关数据库进行了全面的文献综述，重点关注2017年以来发表的学术和临床研究。纳入标准包括随机对照试验和其他观察性研究，比较卒中发生率和利伐沙班在房颤中的安全性指数。我们遵循系统审查和荟萃分析（PRISMA）的首选报告项目进行数据概述报告和概述。根据纳入标准共选择了21项研究。总共有19/21的研究主张采用利伐沙班以最大程度地减少中风发生率。利伐沙班在实现治疗目标方面也显示出优势，即，减少中风的发生率。利伐沙班对抗华法林的结果显示利伐沙班改善了安全性指数和有效性。用于分析的总效应大小计算为Z=2.62(p值=0.009)。所有研究的个体效应都有利于“利伐沙班”组。研究中的异质性如下:tau2=0.10;chi2=110.10,df=6;I2=95%。关于利伐沙班治疗后卒中风险降低和发生率的第二项分析也显示了利伐沙班治疗的偏向。分析的组合效应如下:HR=0.73((95%CI:0.50,1.07)。总效应计算为Z=1.61(p值=0.10)。发现异质性如下:tau2=0.20,chi2=89.97,df=6,I2=93%。利伐沙班的标准剂量已成为预防中风的首选策略，平衡疗效和安全性。临床决策应考虑患者的个体特征，未来的研究应深入研究特定的亚群和长期结果，以进一步完善治疗指南。
