■关于心房颤动(AF)和静脉血栓栓塞(VTE)之间关联的数据存在争议。
■本研究的目的是根据房颤诊断的时间调查房颤患者的VTE风险。
■MEDLINE(PubMed)的系统评价,Embase,护理和相关健康文献累积指数(EBSCO主机),Cochrane中央对照试验登记册(2020年)在Cochrane图书馆,以及世界卫生组织全球指数医学数据库和观察性研究的荟萃分析。静脉血栓栓塞的风险,深静脉血栓(DVT)和肺栓塞(PE)根据房颤发作时间进行分析:1)短(≤3个月);2)中(≤6个月);3)长(>6个月时间组。
■纳入了4,170,027名患者的8项研究,其中650,828人患有AF。短期组,房颤与PE(HR:9.62;95%CI:7.07-13.09;I2=0%)或DVT(HR:6.18;95%CI:4.51-8.49,I2=0%)的最高风险相关。即使在较小的程度上,房颤与较高的VTE风险相关(HR:3.69;95%CI:1.65-8.27;I2=79%),DVT(HR:1.75;95%CI:1.43-2.14;I2=0%),在长达6个月的长期风险组和>6个月的长期风险组(HR:1.39;95%CI:1.00-1.92;I2=72%)和PE(HR:1.08;95%CI:1.00-1.16;I2=0%)。
■在房颤诊断后的前3至6个月,VTE的风险最高,并且随着时间的推移而降低。房颤患者早期开始抗凝治疗可能会降低VTE的风险。
UNASSIGNED: Data on the association between atrial fibrillation (AF) and venous thromboembolism (VTE) are controversial.
UNASSIGNED: The purpose of this study was to investigate the risk of VTE in patients with AF according to the time from AF diagnosis.
UNASSIGNED: Systematic
review of MEDLINE (PubMed), Embase, Cumulative Index to Nursing and Allied Health Literature (EBSCO host), Cochrane Central Register of Controlled Trials (2020) in the Cochrane Library, and World Health Organization Global Index Medicus databases and meta-analysis of observational studies. The risk of VTE, deep vein thrombosis (DVT) and pulmonary embolism (PE) was analyzed according to the time of AF onset: 1) short (≤3 months); 2) medium (≤6 months); and 3) long (>6 months) time groups.
UNASSIGNED: Eight studies were included with 4,170,027 patients, of whom 650,828 with AF. In the short-term group, AF was associated with the highest risk of either PE (HR: 9.62; 95% CI: 7.07-13.09; I2 = 0%) or DVT (HR: 6.18; 95% CI: 4.51-8.49, I2 = 0%). Even if to a lesser extent, AF was associated with a higher risk of VTE (HR: 3.69; 95% CI: 1.65-8.27; I2 = 79%), DVT (HR: 1.75; 95% CI: 1.43-2.14; I2 = 0%), and PE (HR: 4.3; 95% CI: 1.61-11.47; I2 = 68%) in the up to 6 months and long-term risk group >6 months groups (HR: 1.39; 95% CI: 1.00-1.92; I2 = 72%) and PE (HR: 1.08; 95% CI: 1.00-1.16; I2 = 0%).
UNASSIGNED: The risk of VTE is highest in the first 3 to 6 months after AF diagnosis and decreases over time. The early initiation of anticoagulation in patients with AF may reduce the risk of VTE.