Meta-analysis of Efficacy and Safety of Single or Dual Antiplatelet Therapy for Short-term Complications after Transcatheter Aortic Valve Implantation
- VernacularTitle:导管主动脉瓣置换术后抗血小板药单用或双联治疗短期并发症有效性和安全性的Meta分析
- Author:
Yuexin ZHU
1
;
Yusi HUANG
1
;
Huiting CHEN
1
;
Lei ZHANG
1
;
Yang LI
1
;
Ziyuan ZOU
1
;
Qingchun ZENG
1
;
Dingli XU
1
Author Information
1. State Key Laboratory of “Organ Failure Prevention and Treatment ”，the First College of Clinical Medicine，Southern Medical University/Dept. of Cardiovascular Medicine，Nanfang Hospital，Southern Medical University，Guangzhou 510515，China
- Publication Type:Journal Article
- Keywords:
Transcatheter aortic valve implantation;
Antiplatelet;
Aspirin;
Clopidogrel;
Dual;
Single;
Meta- analysis
- From:
China Pharmacy
2019;30(9):1271-1278
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE： To systematically evaluate effectiveness and safety of single antiplatelet therapy （SAPT） versus dual antiplatelet therapy （DAPT） on short-term complications after transcatheter aortic valve implantation （TAVI）， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from PubMed， Cochrane clinical controlled trials registry， Web of Science， CNKI， Wanfang database， CBM and Chinese Clinical Trial Registry， RCTs and observational studies about effectiveness （all-cause mortality， incidence of stroke and incidence of myocardial infarction 30 days after operation） and safety （the incidence of bleeding events at 30 days after operation） of SAPT versus DAPT on short-term complications of TAVI were collected during the date of database establishment to Jan. 2019. After data extraction of included studies and quality evaluation with Cochrane system evaluator manual 5.1.0 （for RCT） and the Newcastle-Ottawa Scale （NOS） （for observational studies）， Meta-analysis was conducted by using Rev Man 5.3 statistical software. RESULTS： Totally 3 RCTs and 7 cohort studies were included， involving 3 188 patients. Results of Meta-analysis showed that the incidence of all-cause mortality 30 days after operation [OR＝0.48， 95％ CI （0.32， 0.73）， P＜0.001] and the incidence of bleeding events 30 days after operation [OR＝0.43， 95％CI （0.30， 0.59）， P＜0.001] in SAPT group were significantly lower than DAPT group， with statistical significance. There was no statistical significance in the incidence of stroke 30 days after operation [OR＝0.63， 95％CI （0.38， 1.06） ， P＝0.08] or the incidence of myocardial infarction 30 days after operation [OR＝1.09， 95％CI （0.46， 2.59）， P＝0.85] between 2 groups. CONCLUSIONS： Compared with DAPT， SAPT can decrease the incidence of all-cause mortality 30 days after TAVI and the incidence of bleeding events 30 days after TAVI.
