利伐沙班与达比加群在行导管消融术的房颤患者中的抗凝疗效及安全性的Meta分析

Meta-analysis of efficacy and safety of rivaroxaban compared with dabigatran in patients undergoing catheter ablation for atrial fibrillation

目的:系统评价利伐沙班与达比加群在导管消融术房颤患者中的抗凝疗效及安全性。方法:采用循证医学的文献分析评价方法,计算机检索Cochrane图书馆、Pubmed、EMbase、中国生物医学文献光盘数据库、中国期刊全文数据库、维普中文科技期刊、万方数字化期刊群等数据库,全面收集利伐沙班与达比加群在导管消融术房颤患者中的抗凝有效性和安全性的随机对照试验、前瞻性研究及回顾性研究。评价纳入研究的方法学质量,提取有效数据,采用Rev Man 5.3软件对数据进行Meta分析。结果:检索到利伐沙班与达比加群的有效性及安全性的随机对照研究、前瞻性研究及回顾性试验共9篇。利伐沙班与达比加群在导管消融术房颤患者中的抗凝疗效及安全性无显著差异。结论:利伐沙班与达比加群在导管消融术房颤患者中的抗凝疗效和安全性相当。

Objective： To evaluate the efficacy and safety of rivaroxaban and dabigatran in atrial fibrillation patients undergoing catheter ablation. Methods： Literature analysis based on evidence-based medicine was performed. Computer retrieval was conducted to search for random controlled trials,prospective studies and retrospective studies of rivaroxaban and dabigatran used in the periprocedural period of catheter ablation for atrial fibrillation. The quality of included studies was evaluated. Data were extracted into a specially designed extraction form. The Cochrane collaboration＇s Rev Man5. 3 software was used for data analysis. Results： The meta-analysis of nine included studies showed no significant difference between rivaroxaban and dabigatran in the efficacy and safety. Conclusion： Our study suggested that the patients treated with rivaroxaban during catheter ablation period had similar incidences of thromboembolic events and major hemorrhage compared with those treated with dabigatran to further validate this finding.