小剂量乙酰水杨酸预防抗磷脂抗体阳性者血栓栓塞事件的有效性和安全性：系统回顾与荟萃分析

IF 3.7 3区医学 Q1 HEMATOLOGY

Thrombosis research Pub Date : 2024-11-26 DOI:10.1016/j.thromres.2024.109225

Federica De Pascali , Yulia Aleksandrovna Filippova , Marco P. Donadini , Vittorio Pengo , Alessandro Squizzato

{"title":"小剂量乙酰水杨酸预防抗磷脂抗体阳性者血栓栓塞事件的有效性和安全性：系统回顾与荟萃分析","authors":"Federica De Pascali , Yulia Aleksandrovna Filippova , Marco P. Donadini , Vittorio Pengo , Alessandro Squizzato","doi":"10.1016/j.thromres.2024.109225","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Anti-Phospholipid Antibodies (aPL) are autoantibodies predisposing to an increased risk of thrombotic events. The net clinical benefit of antithrombotic prophylaxis in aPL carriers is still unclear. We performed a systematic review to assess the efficacy and safety of antiplatelet drugs for the primary prevention of thrombotic events in aPL carriers.</div></div><div><h3>Methods</h3><div>Studies were identified by electronic search of MEDLINE and EMBASE database until May 2023. The differences in the outcomes among groups were estimated as pooled odds ratio (OR) and corresponding 95 % confidence interval (CI). Statistical heterogeneity was evaluated using the I2 statistic.</div></div><div><h3>Results</h3><div>1056 participants were included in 10 studies, 2 RCTs and 8 cohorts. Low-dose acetylsalicylic acid (LDA) was the antiplatelet drug in treated patients. Thrombotic events were significantly reduced in the LDA group compared to the control group [OR 0.46 (95 % CI 0.30–0.71), I2 27%, fixed-effects model]. Arterial thrombotic events were significantly reduced in the LDA group compared to the control group [OR 0.47 (95 % CI 0.26–0.86), I2 0%, fixed-effects model]. Venous thrombotic events were significantly reduced in the LDA group compared to the control group [OR 0.44 (95 % CI 0.21–0.89, I2 1%, fixed-effects model]. No major bleedings occurred in the five studies reporting them.</div></div><div><h3>Conclusions</h3><div>aPL carriers receiving long-term LDA had a significant reduction of thrombotic events, without a significant increase of the risk of major bleeding. It remains unclear if LDA has the same benefit/risk profile in all aPL profile, i.e. single, double, or triple positivity.</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"245 ","pages":"Article 109225"},"PeriodicalIF":3.7000,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Efficacy and safety of low-dose acetylsalicylic acid for the prevention of thromboembolic events in individuals positive for antiphospholipid antibodies: A systematic review and meta-analysis\",\"authors\":\"Federica De Pascali , Yulia Aleksandrovna Filippova , Marco P. Donadini , Vittorio Pengo , Alessandro Squizzato\",\"doi\":\"10.1016/j.thromres.2024.109225\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Anti-Phospholipid Antibodies (aPL) are autoantibodies predisposing to an increased risk of thrombotic events. The net clinical benefit of antithrombotic prophylaxis in aPL carriers is still unclear. We performed a systematic review to assess the efficacy and safety of antiplatelet drugs for the primary prevention of thrombotic events in aPL carriers.</div></div><div><h3>Methods</h3><div>Studies were identified by electronic search of MEDLINE and EMBASE database until May 2023. The differences in the outcomes among groups were estimated as pooled odds ratio (OR) and corresponding 95 % confidence interval (CI). Statistical heterogeneity was evaluated using the I2 statistic.</div></div><div><h3>Results</h3><div>1056 participants were included in 10 studies, 2 RCTs and 8 cohorts. Low-dose acetylsalicylic acid (LDA) was the antiplatelet drug in treated patients. Thrombotic events were significantly reduced in the LDA group compared to the control group [OR 0.46 (95 % CI 0.30–0.71), I2 27%, fixed-effects model]. Arterial thrombotic events were significantly reduced in the LDA group compared to the control group [OR 0.47 (95 % CI 0.26–0.86), I2 0%, fixed-effects model]. Venous thrombotic events were significantly reduced in the LDA group compared to the control group [OR 0.44 (95 % CI 0.21–0.89, I2 1%, fixed-effects model]. No major bleedings occurred in the five studies reporting them.</div></div><div><h3>Conclusions</h3><div>aPL carriers receiving long-term LDA had a significant reduction of thrombotic events, without a significant increase of the risk of major bleeding. It remains unclear if LDA has the same benefit/risk profile in all aPL profile, i.e. single, double, or triple positivity.</div></div>\",\"PeriodicalId\":23064,\"journal\":{\"name\":\"Thrombosis research\",\"volume\":\"245 \",\"pages\":\"Article 109225\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2024-11-26\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Thrombosis research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0049384824003578\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Thrombosis research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0049384824003578","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

摘要

背景抗磷脂抗体（aPL）是一种易增加血栓事件风险的自身抗体。抗血栓预防对 aPL 携带者的净临床获益尚不明确。我们进行了一项系统性综述，以评估抗血小板药物对 aPL 携带者血栓事件一级预防的有效性和安全性。各组间结果的差异以汇总的几率比（OR）和相应的 95 % 置信区间（CI）来估算。统计异质性采用 I2 统计量进行评估。结果 1056 名参与者被纳入 10 项研究，其中包括 2 项 RCT 和 8 项队列研究。小剂量乙酰水杨酸（LDA）是治疗患者的抗血小板药物。与对照组相比，低剂量乙酰水杨酸组血栓事件明显减少[OR 0.46 (95 % CI 0.30-0.71), I2 27%, 固定效应模型]。与对照组相比，LDA 组的动脉血栓事件明显减少 [OR 0.47 (95 % CI 0.26-0.86), I2 0%, 固定效应模型]。与对照组相比，LDA 组静脉血栓事件明显减少[OR 0.44（95 % CI 0.21-0.89，I2 1%，固定效应模型]。结论aPL携带者长期接受LDA治疗，血栓事件明显减少，但大出血风险并未明显增加。目前仍不清楚 LDA 是否对所有 aPL 特征（即单阳性、双阳性或三阳性）具有相同的益处/风险特征。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Efficacy and safety of low-dose acetylsalicylic acid for the prevention of thromboembolic events in individuals positive for antiphospholipid antibodies: A systematic review and meta-analysis

Background

Anti-Phospholipid Antibodies (aPL) are autoantibodies predisposing to an increased risk of thrombotic events. The net clinical benefit of antithrombotic prophylaxis in aPL carriers is still unclear. We performed a systematic review to assess the efficacy and safety of antiplatelet drugs for the primary prevention of thrombotic events in aPL carriers.

Methods

Studies were identified by electronic search of MEDLINE and EMBASE database until May 2023. The differences in the outcomes among groups were estimated as pooled odds ratio (OR) and corresponding 95 % confidence interval (CI). Statistical heterogeneity was evaluated using the I2 statistic.

Results

1056 participants were included in 10 studies, 2 RCTs and 8 cohorts. Low-dose acetylsalicylic acid (LDA) was the antiplatelet drug in treated patients. Thrombotic events were significantly reduced in the LDA group compared to the control group [OR 0.46 (95 % CI 0.30–0.71), I2 27%, fixed-effects model]. Arterial thrombotic events were significantly reduced in the LDA group compared to the control group [OR 0.47 (95 % CI 0.26–0.86), I2 0%, fixed-effects model]. Venous thrombotic events were significantly reduced in the LDA group compared to the control group [OR 0.44 (95 % CI 0.21–0.89, I2 1%, fixed-effects model]. No major bleedings occurred in the five studies reporting them.

Conclusions

aPL carriers receiving long-term LDA had a significant reduction of thrombotic events, without a significant increase of the risk of major bleeding. It remains unclear if LDA has the same benefit/risk profile in all aPL profile, i.e. single, double, or triple positivity.

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

Thrombosis research 医学-外周血管病

CiteScore

14.60

自引率

4.00%

发文量

364

审稿时长

31 days

期刊介绍： Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.