PDF(Pubmed)
Abstract：
BACKGROUND: Since several studies have examined the use of direct oral anticoagulants (DOACs) in treating patients with splanchnic vein thrombosis (SVT), we conducted a meta-analyses to assess the safety and efficacy of DOACs compared to vitamin K antagonists (VKAs) in this population.
METHODS: We conducted a comprehensive search using the PubMed, Embase, and Cochrane Library databases until June 2024. We used odds ratios (ORs) and 95% confidence intervals (CIs) as the effect measures to compare DOACs with VKAs.
RESULTS: A total of 9 observational studies were included. The pooled analysis revealed that a trend towards higher complete recanalization rates with DOACs (71.4%) compared to VKAs (55.3%), though not statistically significant (OR 1.95; 95%CI 0.70 to 5.44). For SVT extension, a significant effect was observed favoring DOACs (OR 0.12; 95%CI 0.03 to 0.54). No significant differences were found in other efficacy outcomes or safety outcomes, except for major bleeding, which was significantly lower with DOACs (OR 0.27; 95%CI 0.13 to 0.56).
CONCLUSIONS: DOACs are superior to VKAs in SVT extension and major bleeding, suggesting that DOACs may be a favorable treatment option in the treatment of SVT.
METHODS: We conducted a comprehensive search using the PubMed, Embase, and Cochrane Library databases until June 2024. We used odds ratios (ORs) and 95% confidence intervals (CIs) as the effect measures to compare DOACs with VKAs.
RESULTS: A total of 9 observational studies were included. The pooled analysis revealed that a trend towards higher complete recanalization rates with DOACs (71.4%) compared to VKAs (55.3%), though not statistically significant (OR 1.95; 95%CI 0.70 to 5.44). For SVT extension, a significant effect was observed favoring DOACs (OR 0.12; 95%CI 0.03 to 0.54). No significant differences were found in other efficacy outcomes or safety outcomes, except for major bleeding, which was significantly lower with DOACs (OR 0.27; 95%CI 0.13 to 0.56).
CONCLUSIONS: DOACs are superior to VKAs in SVT extension and major bleeding, suggesting that DOACs may be a favorable treatment option in the treatment of SVT.
摘要：
背景：由于一些研究已经检查了直接口服抗凝药（DOACs）在治疗内脏静脉血栓形成（SVT）患者中的应用，我们进行了一项荟萃分析,以评估DOACs与维生素K拮抗剂(VKAs)在该人群中的安全性和有效性.
方法：我们使用PubMed进行了全面的搜索，Embase,和Cochrane图书馆数据库，直到2024年6月。我们使用比值比（OR）和95％置信区间（CIs）作为比较DOAC和VKAs的效果指标。
结果：共纳入9项观察性研究。汇总分析显示，与VKAs（55.3％）相比，DOAC（71.4％）的完全再通率更高。虽然没有统计学意义(OR1.95；95CI0.70至5.44)。对于SVT扩展，观察到有利于DOAC的显著效应(OR0.12;95CI0.03至0.54)。在其他疗效结果或安全性结果方面没有发现显著差异，除了大出血,DOAC显著降低(OR0.27；95CI0.13至0.56)。
结论：DOAC在SVT延长和大出血方面优于VKAs，提示DOAC可能是治疗室上性心动过速的有利治疗选择。
方法：我们使用PubMed进行了全面的搜索，Embase,和Cochrane图书馆数据库，直到2024年6月。我们使用比值比（OR）和95％置信区间（CIs）作为比较DOAC和VKAs的效果指标。
结果：共纳入9项观察性研究。汇总分析显示，与VKAs（55.3％）相比，DOAC（71.4％）的完全再通率更高。虽然没有统计学意义(OR1.95；95CI0.70至5.44)。对于SVT扩展，观察到有利于DOAC的显著效应(OR0.12;95CI0.03至0.54)。在其他疗效结果或安全性结果方面没有发现显著差异，除了大出血,DOAC显著降低(OR0.27；95CI0.13至0.56)。
结论：DOAC在SVT延长和大出血方面优于VKAs，提示DOAC可能是治疗室上性心动过速的有利治疗选择。
