METHODS: A systematically comprehensive search was performed covering PubMed, Scopus, ISI Web of Science, and Google Scholar databases.
RESULTS: Twenty-five studies were found including 20 case reports, four case series, and one randomized clinical trial. Of 20 case reports 15 were male (75 %), and five were female (25 %). Of the four the case series, all showed positive outcomes after DAPT plus anticoagulant in more than 50 % of patients; two took only DAPT and 13 took anticoagulant ± DAPT, and five compared both. Cases received DAPT only experienced recurrences of MACE. The other cases were uneventful with less MACE and better outcomes after the use of anticoagulant ± DAPT. Results of these case-series included 457 CAE patients showed that more than 80 % of subjects were male, and in all studies tailored pharmacological interventions, including antiplatelet and anticoagulant (warfarin) therapies, resulted in less MACE and mortality.
CONCLUSIONS: It can be concluded that antiplatelet (SAPT/DAPT) must be applied in combination with anticoagulants to provide more efficient protection against MACE in CAE patients. However, further high-quality randomized clinical trials are needed to confirm the results.
方法:进行了系统全面的搜索,涵盖了PubMed,Scopus,ISIWebofScience,和谷歌学者数据库。
结果:共发现25项研究,包括20例病例报告,四个案例系列,和一项随机临床试验。20例病例报告中有15例为男性(75%),5人是女性(25%)。在四个案例系列中,在超过50%的患者中,所有患者在DAPT+抗凝剂后都显示出阳性结果;2例仅服用DAPT,13例服用抗凝剂±DAPT,五个人比较了两者。接受DAPT的病例仅出现MACE复发。其他病例在使用抗凝剂±DAPT后,MACE较少,预后较好。这些病例系列包括457例CAE患者的结果显示,超过80%的受试者是男性,在所有针对药物干预的研究中,包括抗血小板和抗凝(华法林)治疗,减少MACE和死亡率。
结论:可以得出结论,抗血小板(SAPT/DAPT)必须与抗凝剂联合应用,以提供更有效的CAE患者预防MACE的保护。然而,需要进一步的高质量随机临床试验来确认结果.