دورية أكاديمية
A systematic review and meta-analysis of non-vitamin K antagonist oral anticoagulants vs vitamin K antagonists after transcatheter aortic valve replacement in patients with atrial fibrillation.
| العنوان: | A systematic review and meta-analysis of non-vitamin K antagonist oral anticoagulants vs vitamin K antagonists after transcatheter aortic valve replacement in patients with atrial fibrillation. |
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| المؤلفون: | Ooi AJQ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Wong C; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Tan TWE; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Ng TP; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Teo YN; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Teo YH; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Syn NL; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore., Djohan AH; Department of Cardiology, National University Heart Centre, Singapore, 119228, Singapore., Lim Y; Department of Cardiology, National University Heart Centre, Singapore, 119228, Singapore., Yeo LLL; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Division of Neurology, Department of Medicine, National University Hospital, Singapore, Singapore., Tan BYQ; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Division of Neurology, Department of Medicine, National University Hospital, Singapore, Singapore., Chan MY; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Department of Cardiology, National University Heart Centre, Singapore, 119228, Singapore., Poh KK; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Department of Cardiology, National University Heart Centre, Singapore, 119228, Singapore., Kong WKF; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Department of Cardiology, National University Heart Centre, Singapore, 119228, Singapore., Chai P; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Department of Cardiology, National University Heart Centre, Singapore, 119228, Singapore., Yeo TC; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Department of Cardiology, National University Heart Centre, Singapore, 119228, Singapore., Yip JW; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.; Department of Cardiology, National University Heart Centre, Singapore, 119228, Singapore., Kuntjoro I; Department of Cardiology, National University Heart Centre, Singapore, 119228, Singapore., Sia CH; Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. ching_hui_sia@nuhs.edu.sg.; Department of Cardiology, National University Heart Centre, Singapore, 119228, Singapore. ching_hui_sia@nuhs.edu.sg. |
| المصدر: | European journal of clinical pharmacology [Eur J Clin Pharmacol] 2022 Oct; Vol. 78 (10), pp. 1589-1600. Date of Electronic Publication: 2022 Aug 09. |
| نوع المنشور: | Journal Article; Meta-Analysis; Review; Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: Germany NLM ID: 1256165 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-1041 (Electronic) Linking ISSN: 00316970 NLM ISO Abbreviation: Eur J Clin Pharmacol Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Berlin, New York, Springer. |
| مواضيع طبية MeSH: | Atrial Fibrillation*/complications , Brain Ischemia*/drug therapy , Stroke*/drug therapy , Stroke*/epidemiology , Stroke*/prevention & control , Transcatheter Aortic Valve Replacement*/adverse effects, Administration, Oral ; Anticoagulants/therapeutic use ; Fibrinolytic Agents/therapeutic use ; Hemorrhage/chemically induced ; Humans ; Treatment Outcome |
| مستخلص: | Purpose: Transcatheter aortic valve replacement (TAVR) is increasingly carried out in patients with aortic valvular conditions. Atrial fibrillation (AF) is a common comorbidity among patients undergoing TAVR. Despite this, there remains a paucity of data and established guidelines regarding anticoagulation use post-TAVR in patients with AF. Methods: Four databases were searched from inception until 12 October 2021. A title and abstract sieve, full-text review and data extraction were conducted by independent authors, and articles including patients without AF were excluded. The Review Manager (Version 5.4) was utilised in data analysis. Results: A total of 25,199 post-TAVR patients with AF were included from seven articles, with 9764 patients on non-vitamin K antagonist oral anticoagulants (NOAC) and 15,435 patients on vitamin K antagonists (VKA). In this analysis, there was a significantly lower risk of all-cause mortality at 1 year (RR: 0.75, CI: 0.58-0.97, p = 0.04, I 2 = 56%), and bleeding at 1 year (RR: 0.73, CI: 0.68-0.79, p = < 0.00001, I 2 = 0%), between patients on NOAC and VKA. There were no detectable differences between patients on NOAC and VKA for all-cause mortality at 2 years, stroke within 30 days, stroke within 1 year, ischaemic stroke at 1 year and life-threatening bleeding at 30 days. Conclusion: While the results of this analysis reveal NOAC as a potential alternate treatment modality to VKA in post-TAVR patients with AF, further research is needed to determine the full safety and efficacy profile of NOAC (PROSPERO: CRD42021283548). (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.) |
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| فهرسة مساهمة: | Keywords: Atrial fibrillation (AF); Meta-analysis; Non-vitamin K antagonists oral anticoagulants (NOAC); Transcatheter aortic valve replacement (TAVR); Vitamin K antagonist (VKA) |
| المشرفين على المادة: | 0 (Anticoagulants) 0 (Fibrinolytic Agents) |
| تواريخ الأحداث: | Date Created: 20220808 Date Completed: 20220920 Latest Revision: 20220920 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1007/s00228-022-03371-6 |
| PMID: | 35941300 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1432-1041 |
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| DOI: | 10.1007/s00228-022-03371-6 |