A meta analysis of antiplatelet therapy after transcatheter aortic valve implantation

Hao Wang; Fanhua Meng; Xiang MA; Yitong MA

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A meta analysis of antiplatelet therapy after transcatheter aortic valve implantation

VernacularTitle:M eta 分析：经导管主动脉瓣置入术后抗血小板治疗的有效性和安全性
Author: Hao WANG ; Fanhua MENG ; Xiang MA ; Yitong MA
Publication Type:Journal Article
Keywords: Transcatheter aortic valve implantation; Antiplatelet therapy; Meta analysis
From: Chinese Journal of Interventional Cardiology 2016;24(9):515-520
CountryChina
Language:Chinese
Abstract: Objective To assess the efficacy and safety of antiplatelet threapy after transcatheter aortic valve implantation.Methods Databases including PubMed , EMBASE, MEDLINE, the Cochrane Library, CMB and CNKI were searched to collect the randomized controlled trials ( RCTs) and cohort study trials ( CSTs ) about the efficacy and safety of antiplatelet threapy after transcatheter aortic valve implantation.The literature was screened according to the inclusive and exclusive criteria by two reviewers independently.The quality was evaluated.The data were extracted and meta-analyses were performed by using RevMan 5.3 software.Results 4 trials were included, of which 2 were RCTs involving 199 patients, and 2 were cohort studies involving 441 patients.Efficacy analysis showed that there were no differences between mono versus dual antiplatelet therapy in terms of 30-day rates of stroke ( OR 0.55 ,95%CI:0.22-1.35 ,P =0.19 ) , myocardial infarction ( OR 1.70 , 95% CI:0.25 -11.65 , P =0.59 ) , and all-cause mortality ( OR 0.77 , 95% CI:0.40 -1.49 , P =0.44 ) .Safety analysis showed that mono antiplatelet therapy had lower incidence of bleeding events , compared to dual antiplatelet therapy ( OR 0.37 , 95%CI:0.23-0.59,P<0.0001).Conclusions Mono versus dual antiplatelet therapy in the prevention of stroke , myocardial infarction and all-cause mortality after TAVI has similar protective effects .Mono antiplatelet threapy presents lower bleeding event rate .Due to limited quality and quantity of the included studies , the above conclusions need to be verified by more high quality studies .