Oral anticoagulation and antiplatelet therapy after transcatheter aortic valve replacement: A systematic review and Meta-analysis
10.3760/cma.j.issn.0254-9026.2020.03.022
- VernacularTitle:经导管主动脉瓣置换术后口服抗凝药与抗血小板治疗的Meta分析
- Author:
Chengcheng WANG
1
;
Qingliang CHEN
;
Bo FU
;
Nan JIANG
Author Information
1. 天津医科大学研究生院，天津 300070
- From:
Chinese Journal of Geriatrics
2020;39(3):345-349
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To assess the efficacy and safety of different antithrombotic strategies in patients following transcatheter aortic valve replacement(TAVR).Methods:A computerized search was performed to identify all relevant publications from PubMed, EMbase, CNKI and Wangfang databases.Non-randomized controlled trials of oral anticoagulant(OAC) vs. antiplatelet therapy(APT)and vitamin K antagonists(VKAs) vs. non-vitamin K antagonist oral anticoagulants(NOACs)after TAVR were collected, and the effects on postoperative bleeding, cerebrovascular events and all-cause mortality were analyzed.A meta-analysis was performed using RevMan 5.2 software provided by the Cochrane Collaboration. Results:A total of 9 studies were included.Compared with APT, the incidence of bleeding events caused by OAC increased(20.3% vs. 26.3%, OR=1.20, 95% CI: 1.04-1.39, P=0.01), while the incidence of cardiovascular events and all-cause mortality had no statistical difference.In the OAC group, all-cause mortality was lower in the VKAs group than in the NOACs group(9.8% vs. OR=0.73, 95% CI: 0.55-0.97, P=0.03). However, there was no statistical significance in cardiovascular and bleeding events( P>0.05). Conclusions:Compared with patients receiving APT, the incidence of bleeding events is higher in patients taking OAC.In patients taking OAC, VKAs can significantly decrease the mortality compared with NOACs.
