Efficacy and safety of oral anticoagulants in patients with atrial fibrillation and acute myocardial infarction: a systematic review and meta-analysis.

IF 3.6 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Postgraduate Medical Journal Pub Date : 2025-04-02 DOI:10.1093/postmj/qgaf046

Yi Zheng, Xinyu Zheng, George Bazoukis, Gary Tse, Tong Liu

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引用次数: 0

Abstract

Background: The optimal antithrombotic therapy strategies for patients with atrial fibrillation (AF) and acute myocardial infarction (AMI) remain uncertain. We aimed to evaluate the efficacy and safety of oral anticoagulants (OAC) among patients with AF and AMI.

Methods: PubMed, Embase, and Web of Science were searched from inception till 5 February 2025. The primary outcome was any stroke.

Results: Eleven studies with 83 549 patients were included. OAC therapy was associated with lower risks of any stroke (odds ratio [OR]: 0.68; 95% confidence interval [CI]: 0.60-0.77; P < .001), ischemic stroke (OR: 0.64; 95% CI: 0.57-0.73; P < .001), and all-cause mortality (OR: 0.81; 95% CI: 0.74-0.89; P < .001). Additionally, OAC therapy was associated with a higher risk of any bleeding (OR: 1.24; 95% CI: 1.06-1.46; P = .009), but not for major bleeding (OR: 1.28; 95% CI: 0.87-1.90; P = .21).

Conclusions: OAC therapy is effective for patients with AF and AMI, but should be administered cautiously in those at high bleeding risk.

查看原文本刊更多论文

心房颤动和急性心肌梗死患者口服抗凝剂的疗效和安全性：一项系统回顾和荟萃分析。

背景：心房颤动（AF）和急性心肌梗死（AMI）患者的最佳抗血栓治疗策略仍不确定。我们的目的是评估口服抗凝剂（OAC）在AF和AMI患者中的疗效和安全性。方法：检索PubMed、Embase和Web of Science自建站至2025年2月5日。主要结局是卒中。结果：纳入11项研究，共83 549例患者。OAC治疗与较低的卒中风险相关(优势比[OR]: 0.68；95%置信区间[CI]: 0.60-0.77；结论：OAC治疗对房颤和AMI患者有效，但对出血风险高的患者应谨慎使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Postgraduate Medical Journal 医学-医学：内科

CiteScore

8.50

自引率

2.00%

发文量

131

审稿时长

2.5 months

期刊介绍： Postgraduate Medical Journal is a peer reviewed journal published on behalf of the Fellowship of Postgraduate Medicine. The journal aims to support junior doctors and their teachers and contribute to the continuing professional development of all doctors by publishing papers on a wide range of topics relevant to the practicing clinician and teacher. Papers published in PMJ include those that focus on core competencies; that describe current practice and new developments in all branches of medicine; that describe relevance and impact of translational research on clinical practice; that provide background relevant to examinations; and papers on medical education and medical education research. PMJ supports CPD by providing the opportunity for doctors to publish many types of articles including original clinical research; reviews; quality improvement reports; editorials, and correspondence on clinical matters.