Efficacy and safety of new oral anticoagulants in patients with nonvalvular atrial fibrillation after left atrial appendage occlusion：a meta-analysis
- VernacularTitle:NOACs用于非瓣膜性房颤患者左心耳封堵术后抗栓疗效和安全性的Meta分析
- Author:
Qiaoling YU
1
;
Weiwei ZHAI
1
;
Ping LIU
1
;
Bo QIU
2
;
Huizhen WU
3
Author Information
1. Graduate School of Hebei Medical University，Shijiazhuang 050017，China;Dept. of Pharmacy，Hebei General Hospital，Shijiazhuang 050051，China
2. Dept. of Pharmacy，Hebei General Hospital，Shijiazhuang 050051，China
3. Graduate School of Hebei Medical University，Shijiazhuang 050017，China
- Publication Type:Journal Article
- Keywords:
new oral anticoagulants;
nonvalvular atrial
- From:
China Pharmacy
2023;34(16):2008-2013
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To systematically evaluate the efficacy and safety of new oral anticoagulants （NOACs） in patients with nonvalvular atrial fibrillation after left atrial appendage occlusion （LAAO）. METHODS Retrieved from PubMed， Embase， Web of Science， the Cochrane Library， CNKI and Wanfang data， randomized controlled trials （RCTs） and cohort studies about NOACs （trial group） versus warfarin or dual antiplatelet agents （control group） were collected during the inception and November 2022. After literature screening， data extraction and quality evaluation， meta-analysis was performed by using RevMan 5.4 software. RESULTS A total of 10 studies were included， involving 2 RCTs and 8 cohort studies， with a total of 2 653 patients. RCT results showed that there was no statistically significant difference in the incidence of device-related thrombosis （DRT）， stroke/ systemic embolism （SSE）， major bleeding events， total bleeding events or all-cause mortality between 2 groups （P＞0.05）. Results of cohort studies showed that compared with dual antiplatelet agents， there was no statistically significant difference in the incidence of DRT， stroke/SSE， major bleeding events or all-cause mortality in the trial group （P＞0.05）. Compared with warfarin， the incidence of DRT [RR＝0.40， 95%CI （0.19，0.82）， P＝0.01] and total bleeding events [RR＝0.28， 95%CI （0.18， 0.44）， P＜ 0.000 01] in the trial group were decreased significantly； there was no statistical significance in the incidence of stroke/SSE， major bleeding events or all-cause mortality （P＞0.05）. CONCLUSIONS For patients with nonvalvular atrial fibrillation after LAAO， NOACs have comparable antithrombotic efficacy and safety with dual antiplatelet agents， and the incidence of DRT and total bleeding events are lower than warfarin.
