直接口服抗凝剂与维生素K拮抗剂治疗左心室血栓疗效和安全性的meta分析

IF 0.2 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Gian Chand, Abdul Hameed, Rukhsar Bibi, Iram Jehan Balouch, Ijaz Ul Haq, Muhammad Tahseen Raza, Ahmed Raheem
{"title":"直接口服抗凝剂与维生素K拮抗剂治疗左心室血栓疗效和安全性的meta分析","authors":"Gian Chand, Abdul Hameed, Rukhsar Bibi, Iram Jehan Balouch, Ijaz Ul Haq, Muhammad Tahseen Raza, Ahmed Raheem","doi":"10.47144/phj.v56i3.2611","DOIUrl":null,"url":null,"abstract":"Objectives: The objective of this updated meta-analysis is to consolidate high-quality peer-reviewed clinical evidence, including trials and observational studies, to evaluate the efficacy and safety of “direct oral anticoagulants (DOACs)” versus “vitamin K antagonists (VKAs)” for treating “left ventricular thrombus (LVT)”. Methodology: We included studies of either \"observational\" or \"experimental\" in nature reported original data for the head-to-head comparison of \"DOACs\" and \"VKAs\" for the treatment of LVT. The efficacy-related outcome of interest was \"thrombus resolution\" and safety-related outcomes of interest were; \"mortality\", \"major bleeding\", and \"stroke\". The “risk ratios (RRs)” for each outcome variable were calculated using the “Mantel-Haenszel method”. Results: The analysis included 19 studies comprised of 3,027 patients diagnosed with LVT. Among them, 881 received DOAC treatment, while 2,146 were treated with VKAs. DOACs showed comparable rates of LVT resolution (RR: 1.00 [0.93 – 1.08]), lower mortality incidence (RR: 0.65 [0.51 – 0.84]), similar stroke incidence (RR: 0.83 [0.61 – 1.14]), and similar major bleeding incidence (RR: 0.71 [0.50 – 1.00]) compared to VKAs. Conclusion: The meta-analysis indicates that DOACs are as effective as VKAs for treating LVT, showing comparable thrombus resolution rates, lower all-cause mortality, similar stroke risks, and clinically relevant bleeding across studies. However, these conclusions are limited by the lack of evidence from large-scale randomized studies and high-quality real-life clinical data.","PeriodicalId":42273,"journal":{"name":"Pakistan Heart Journal","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A Meta-Analysis for the Efficacy and Safety of Direct Oral Anticoagulants versus Vitamin K Antagonists for Left Ventricular Thrombus\",\"authors\":\"Gian Chand, Abdul Hameed, Rukhsar Bibi, Iram Jehan Balouch, Ijaz Ul Haq, Muhammad Tahseen Raza, Ahmed Raheem\",\"doi\":\"10.47144/phj.v56i3.2611\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Objectives: The objective of this updated meta-analysis is to consolidate high-quality peer-reviewed clinical evidence, including trials and observational studies, to evaluate the efficacy and safety of “direct oral anticoagulants (DOACs)” versus “vitamin K antagonists (VKAs)” for treating “left ventricular thrombus (LVT)”. Methodology: We included studies of either \\\"observational\\\" or \\\"experimental\\\" in nature reported original data for the head-to-head comparison of \\\"DOACs\\\" and \\\"VKAs\\\" for the treatment of LVT. The efficacy-related outcome of interest was \\\"thrombus resolution\\\" and safety-related outcomes of interest were; \\\"mortality\\\", \\\"major bleeding\\\", and \\\"stroke\\\". The “risk ratios (RRs)” for each outcome variable were calculated using the “Mantel-Haenszel method”. Results: The analysis included 19 studies comprised of 3,027 patients diagnosed with LVT. Among them, 881 received DOAC treatment, while 2,146 were treated with VKAs. DOACs showed comparable rates of LVT resolution (RR: 1.00 [0.93 – 1.08]), lower mortality incidence (RR: 0.65 [0.51 – 0.84]), similar stroke incidence (RR: 0.83 [0.61 – 1.14]), and similar major bleeding incidence (RR: 0.71 [0.50 – 1.00]) compared to VKAs. Conclusion: The meta-analysis indicates that DOACs are as effective as VKAs for treating LVT, showing comparable thrombus resolution rates, lower all-cause mortality, similar stroke risks, and clinically relevant bleeding across studies. However, these conclusions are limited by the lack of evidence from large-scale randomized studies and high-quality real-life clinical data.\",\"PeriodicalId\":42273,\"journal\":{\"name\":\"Pakistan Heart Journal\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.2000,\"publicationDate\":\"2023-09-30\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pakistan Heart Journal\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.47144/phj.v56i3.2611\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pakistan Heart Journal","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.47144/phj.v56i3.2611","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0

摘要

目的:这项最新荟萃分析的目的是巩固高质量的同行评审临床证据,包括试验和观察性研究,以评估“直接口服抗凝剂(DOACs)”与“维生素K拮抗剂(VKAs)”治疗“左室血栓(LVT)”的有效性和安全性。方法:我们纳入了“观察”或“实验”性质的研究,报道了“doac”和“vka”治疗LVT的直接比较的原始数据。与疗效相关的结果是“血栓消退”,与安全性相关的结果是;"死亡率" "大出血"和"中风"采用“Mantel-Haenszel法”计算各结果变量的“风险比(rr)”。结果:该分析包括19项研究,包括3027例诊断为LVT的患者。其中DOAC治疗881例,vka治疗2146例。与vka相比,doac的LVT消退率(RR: 1.00[0.93 - 1.08])、死亡率(RR: 0.65[0.51 - 0.84])、卒中发生率(RR: 0.83[0.61 - 1.14])和大出血发生率(RR: 0.71[0.50 - 1.00])相似。结论:荟萃分析表明,DOACs与vka在治疗LVT方面同样有效,各研究显示出相似的血栓溶解率、更低的全因死亡率、相似的卒中风险和临床相关出血。然而,这些结论受到缺乏大规模随机研究证据和高质量真实临床数据的限制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A Meta-Analysis for the Efficacy and Safety of Direct Oral Anticoagulants versus Vitamin K Antagonists for Left Ventricular Thrombus
Objectives: The objective of this updated meta-analysis is to consolidate high-quality peer-reviewed clinical evidence, including trials and observational studies, to evaluate the efficacy and safety of “direct oral anticoagulants (DOACs)” versus “vitamin K antagonists (VKAs)” for treating “left ventricular thrombus (LVT)”. Methodology: We included studies of either "observational" or "experimental" in nature reported original data for the head-to-head comparison of "DOACs" and "VKAs" for the treatment of LVT. The efficacy-related outcome of interest was "thrombus resolution" and safety-related outcomes of interest were; "mortality", "major bleeding", and "stroke". The “risk ratios (RRs)” for each outcome variable were calculated using the “Mantel-Haenszel method”. Results: The analysis included 19 studies comprised of 3,027 patients diagnosed with LVT. Among them, 881 received DOAC treatment, while 2,146 were treated with VKAs. DOACs showed comparable rates of LVT resolution (RR: 1.00 [0.93 – 1.08]), lower mortality incidence (RR: 0.65 [0.51 – 0.84]), similar stroke incidence (RR: 0.83 [0.61 – 1.14]), and similar major bleeding incidence (RR: 0.71 [0.50 – 1.00]) compared to VKAs. Conclusion: The meta-analysis indicates that DOACs are as effective as VKAs for treating LVT, showing comparable thrombus resolution rates, lower all-cause mortality, similar stroke risks, and clinically relevant bleeding across studies. However, these conclusions are limited by the lack of evidence from large-scale randomized studies and high-quality real-life clinical data.
求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Pakistan Heart Journal
Pakistan Heart Journal CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
0.20
自引率
0.00%
发文量
64
审稿时长
6 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信