Comparison of efficacy and safety between new oral anticoagulants and traditional anticoagulants in patients with liver cirrhosis requiring anticoagulant therapy
10.3760/cma.j.cn501113-20200921-00522
- VernacularTitle:新型口服抗凝剂和传统抗凝剂在需要抗凝治疗的肝硬化患者中的疗效与安全性比较
- Author:
Tianchen LIU
1
;
Hua XU
;
Yu LEI
;
Shan ZHONG
;
Zhi ZHOU
Author Information
1. 重庆医科大学附属第二医院感染科，重庆 400010
- Keywords:
Liver cirrhosis;
New oral anticoagulants;
Traditional anticoagulants;
Meta-analysis
- From:
Chinese Journal of Hepatology
2022;30(6):598-605
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the advantages and disadvantages of new oral anticoagulants (NOACs) with traditional anticoagulants, in an attempt to evaluate their efficacy and safety in patients with liver cirrhosis requiring anticoagulant therapy.Methods:Relevant literatures were searched from PubMed, Embase, Cochrane Library, HowNet, Wanfang, VIP and other databases by computer retrieval. The literatures quality was evaluated by NOS. The extracted data were meta-analyzed by RevMan5.3 software.Results:A total of seven studies were included, including one randomized controlled trial and six retrospective cohort studies with a total of 3042 cases. Among them, 1677 and 1365 cases used NOACs and traditional anticoagulants. Meta-analysis results showed that compared with the traditional anticoagulant group, the NOACs group had a lower incidence of massive hemorrhage [ OR=0.56, 95% CI (0.37-0.85), P＜0.01] and a higher thrombotic recanalization rate [ OR=7.77, 95% CI (3.48~17.34), P＜0.01], and the difference was statistically significant, while there were no statistically significant differences between the two groups in comparison to all-cause bleeding rates [ OR=0.72, 95% CI (0.13-3.91), P=0.07], all-cause mortality [ OR=0.72, 95% CI (0.25-2.07), P=0.54], recurrent embolism and stroke rates [ OR=0.90, 95% CI (0.59-1.39), and P=0.64]. Conclusion:Compared with traditional anticoagulants, NOACs have higher safety and better efficacy in the treatment of patients with liver cirrhosis, but it has not been widely used in China. Therefore, large-scale randomized controlled trials and prospective studies are further needed to confirm it in the future.
