Effects of Dual-antiplatelet Medication Time on Efficacy and Safety of Postoperative Complications after Transcatheter Aortic Valve Implantation ：A Meta-analysis
- VernacularTitle:经导管主动脉瓣置换术后双联抗血小板用药时间对术后并发症疗效和安全性影响的Meta分析
- Author:
Yuexin ZHU
1
;
Yusi HUANG
1
;
Huiting CHEN
1
;
Lei ZHANG
1
;
Yang LI
1
;
Qingchun ZENG
1
;
Dingli XU
1
Author Information
1. Dept. of Cardiology，the First School of Clinical Medicine/Nanfang Hospital，Southern Medical University，Guangzhou 510515，China
- Publication Type:Journal Article
- Keywords:
Transcatheter aortic valve implantation;
Dual-antiplatelet therapy;
Medication time;
Postoperative complication;
Efficacy;
Safety;
Meta-analysis
- From:
China Pharmacy
2019;30(13):1847-1853
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE： To systematically evaluate the effects of dual-antiplatelet medication time on efficacy and safety of postoperative complications after transcatheter aortic valve implantation （TAVI）， and to provide evidence-based reference for the formulation of antiplatelet therapy after TAVI. METHODS： Retrieved from Cochrane clinical controlled trial registration center， PubMed， Embase， Web of Science， Wanfang database and CJFD， during database establishment to Feb. 2019， RCTs and observational study about efficacy （all-cause mortality and incidence of stroke） and safety （the incidence of major bleeding events） the effects of dual-antiplatelet therapy for postoperative complications after TAVI at different time points were collected. After data extraction of clinical studies met inclusion criteria， quality evaluation with Cochrane bias risk evaluation tool 5.1.0 （for RCT） or Newcastle- Ottawa Scale （for observational study）， Meta-analysis was conducted by using Rev Man 5.3 and Stata 14.0 statistical software. Meta-regression analysis was also conducted for outcome and different treatment duration. RESULTS： A total of 3 RCTs and 10 observational studies were included， involving 2 868 patients. The results of Meta-analysis showed that the incidence of all-cause mortality one month and 6 months after medication were 0.05 [95％CI （0.03， 0.07）， P＜0.001] and 0.07 [95％CI （0.05， 0.08）， P＜0.001]. The incidence of major bleeding events 1， 3 and 6 months after medication were 0.14 [95％CI （0.08，0.19）， P＜0.001]， 0.11 [95％CI （0.03， 0.19）， P＝0.007] and 0.13 [95％CI （0.05， 0.22）， P＝0.002]. The incidence of stroke after one month after medication was 0.04 [95％CI （0.03， 0.05）， P＜0.001]. Results of Meta-regression analysis showed that the all-caused mortality [regression coefficient＝0.005 7， 95％CI （－0.001 6， 0.013 0）， P＝0.116]， major bleeding [regression coefficient＝－0.000 5，95％CI（－0.022 4，0.021 4）， P＝0.959] or the incidence of stroke [regression coefficient＝0.001 4， 95％CI （－0.003 8， 0.006 5）， P＝0.570] were not related to medication duration of dual-antiplatelet therapy. CONCLUSIONS： The prolongation of the medication time of the dual-antiplatelet therapy has no significant effect on the efficacy and safety of TAVI.
