Comparison of two monitoring methods for oral anticoagulant therapy: a meta-analysis
10.3760/cma.j.issn.1001-4497.2010.02.011
- VernacularTitle:口服抗凝治疗两种监测方法的Meta分析
- Author:
Xi ZHANG
;
Zhe XU
;
Baiyun TANG
;
Yanling CHEN
;
Zhiping WANG
;
Zhongkai WU
;
Shengli YIN
- Publication Type:Journal Article
- Keywords:
Heart valve prosthesis implantation;
Anticoagulants;
Meta analysis;
Vitamin K;
Coomarius Self-care
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2010;26(2):100-104
- CountryChina
- Language:Chinese
-
Abstract:
Objective Both underuse and overuse of anticoagulant therapy may lead to severe adverse effects. Emerging portable monitering devices, which provides reliable and accurate measurements, were reported to be potential alternatives to tra-ditional monitering recta-analysis regimens. This study was intended to evaluate the effects of serf-monitoring or serf-management (self-testing and serf-dosing) of anticoagulant as compared with that of traditional monitoring. Methods Relevant trials reported before October 2008 were identified in a number of electronic database and analyzed with software RevMan 4.2. The primary out-comes included death from any cause, major bleeding event, thromboembolic event and the proportion of patients whose interna-tional normalized ratio (INR) were within the therapeutic range. Results Seventeen RCT of serf-monitoring were identified.Pooled estimates revealed significant reductions in the thromboembolic events (odds ratio 0.46, 95% CI0.33 -0.64), all-cause mortality (0.61,0.40 -0.93), and major haemorrhage (0.80, 0.58 - 1.10) with self-monitoring as comparing with traditional monitoring. No difference was noted in minor haemorrhage. 15 trials reported improvements in the mean proportion of patients whose INR were within target range. Conclusion Self-management regimen is superior to traditional monitoring in the outcomes of oral anticoagulation. Patients capable of self-monitoring and serf-adjusting have fewer thromboembolic events and lower mortali-ty than those undergoing self-monitoring alone. However, self-monitoring requires education and training for patients.
