新型口服抗凝药和左心耳封堵器在非瓣膜性心房颤动运用中的有效性及安全性的Meta分析

何贵均; 熊青松; 胡骏豪; 刘嘉玲; 周骐

doi:10.13201/j.issn.1001-1439.2019.07.015

新型口服抗凝药和左心耳封堵器在非瓣膜性心房颤动运用中的有效性及安全性的Meta分析

- 1 重庆医科大学附属第二医院心内科(重庆,400010);2 成都市第三人民医院
基金项目:
国家自然科学基金 (No:81370404)

详细信息

通讯作者: 周骐, E-mail:drzhouqi@126.com

中图分类号: R541.75

收稿日期: 2019-02-19

Efficacy and safety of new oral anticoagulants and left atrial appendage occlusion devices in non-valvular atrial fibrillation:a Meta-analysis

- 1 The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China;

More Information

Corresponding author: ZHOU Qi, E-mail: drzhouqi@126.com

Received Date: 19 February 2019

摘要

摘要: 目的:运用Meta分析方法研究新型口服抗凝药 (NOAC) 和左心耳封堵器 (LAAO) 在非瓣膜性心房颤动 (房颤) 运用中的安全性及有效性。方法:计算机检索Pubmed、Embase及Cochrane数据库有关新型口服抗凝药和左心耳封堵器的文章, 包括随机对照实验 (RCT) 、病例登记及观察性研究。主要结局指标为缺血性卒中和大出血, 次要结局指标包括出血性休克、总的卒中和心血管死亡。结果:共纳入29篇文章, 总例数为81 597例。汇总分析表明, LAAO的大出血发生率较NOAC更低 (1.1/PY∶2.7/PY) , LAAO缺血性卒中的发生率较NOAC稍高 (1.8/PY∶1.2/PY) 。结论:NOAC较LAAO发生大出血风险更高, 但缺血性卒中风险发生可能较低。
- 心房颤动 /
- 左心耳封堵器 /
- 新型口服抗凝药 /
- Meta分析
Abstract: Objective:Meta-analysis was used to research the effectiveness and safety of left atrial appendage occlusion devices (LAAO) and new oral anticoagulants (NOAC) in non-valvular atrial fibrillation.Method:Pubmed, Embase and Cochrane were searched for articles about NOAC and LAAO, including randomized controlled trials (RCT) , case registration and observational studies.The main outcome indicators were ischemic stroke and major bleeding.The secondary outcome indicators included hemorrhagic shock, total stroke and cardiovascular death.Result:A total of 29 articles with 81 597 cases were included.The summary analysis showed that the incidence of major bleeding in LAAO group was lower than that in NOAC group (1.1/PY vs.2.7/PY) , while the incidence ischemic stroke in LAAO group was slightly higher than that in NOAC group (1.8/PY vs.1.2/PY) .Conclusion:The risk of major bleeding is higher in NOAC, however, the rate of ischemic stroke may be lower.
- atrial fibrillation /
- left atrial appendage occluder /
- new oral anticoagulant /
- Meta analysis

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