UNASSIGNED: Several databases, including MEDLINE, Google Scholar, and EMBASE, were electronically searched. The primary endpoint was the all-cause mortality (ACM) rate. Secondary endpoints included cardiovascular death, myocardial infarction (MI), stroke/TIA, haemorrhagic stroke, bleeding events, systemic embolism, and valve thrombosis in post-TAVR patients receiving APT and oral anticoagulants (OACs). Forest plots were generated using Review Manager version 5.4, with a p value less than 0.05 indicating statistical significance. Subgroup analysis was performed to explore potential sources of heterogeneity.
UNASSIGNED: Twelve studies were selected. No significant differences were observed in APT and OAC group for ACM [risk ratio (RR): 0.67; 95% CI:0.45-1.01; P=0.05], cardiovascular death [RR:0.91; 95% CI:0.73-1.14; P=0.42], MI [RR:1.69; 95% CI:0.43-6.72; P=0.46], Stroke/TIA [RR:0.79; 95% CI:0.58-1.06; P=0.12], ischaemic stroke [RR:0.83; 95% CI:0.50-1.37; P=0.47], haemorrhagic stroke [RR:1.08; 95% CI: 0.23-5.15; P=0.92], major bleeding [RR:0.79; 95% CI:0.51-1.21; P=0.28], minor bleeding [RR:1.09; 95% CI: 0.80-1.47; P=0.58], life-threatening bleeding [RR:0.85; 95% CI:0.55-1.30; P=0.45], any bleeding [RR:0.98; 95% CI:0.83-1.15; P=0.78], and systemic embolism [RR:0.87; 95% CI:0.44-1.70; P=0.68]. The risk of valve thrombosis was higher in patients receiving APT than in those receiving OAC [RR:2.61; 95% CI:1.56-4.36; P =0.0002].
UNASSIGNED: Although the risk of valve thrombosis increased in patients receiving APT, the risk of other endpoints was comparable between the two groups.
■几个数据库,包括MEDLINE,谷歌学者,和EMBASE,电子搜索。主要终点是全因死亡率(ACM)。次要终点包括心血管死亡,心肌梗死(MI),中风/TIA,出血性中风,出血事件,全身性栓塞,接受APT和口服抗凝剂(OAC)的TAVR后患者的瓣膜血栓形成。使用ReviewManager版本5.4生成森林地块,p值小于0.05,表明有统计学意义。进行亚组分析以探索异质性的潜在来源。
■选择了12项研究。APT和OAC组ACM无显著差异[风险比(RR):0.67;95%CI:0.45-1.01;P=0.05],心血管死亡[RR:0.91;95%CI:0.73-1.14;P=0.42],MI[RR:1.69;95%CI:0.43-6.72;P=0.46],卒中/TIA[RR:0.79;95%CI:0.58-1.06;P=0.12],缺血性卒中[RR:0.83;95%CI:0.50-1.37;P=0.47],出血性卒中[RR:1.08;95%CI:0.23-5.15;P=0.92],大出血[RR:0.79;95%CI:0.51-1.21;P=0.28],轻微出血[RR:1.09;95%CI:0.80-1.47;P=0.58],危及生命的出血[RR:0.85;95%CI:0.55-1.30;P=0.45],任何出血[RR:0.98;95%CI:0.83-1.15;P=0.78],和全身性栓塞[RR:0.87;95%CI:0.44-1.70;P=0.68]。接受APT的患者发生瓣膜血栓形成的风险高于接受OAC的患者[RR:2.61;95%CI:1.56-4.36;P=0.0002]。
■尽管接受APT的患者瓣膜血栓形成的风险增加,两组的其他终点风险相当.