新型口服抗凝剂在亚洲房颤患者中疗效和安全性的Meta分析

Meta-analysis of efficacy and safety of new oral anticoagulants in Asian patients with atrial fibrillation

目的评价新型抗凝药(NOACs)对亚洲心房颤动(房颤,AF)患者脑卒中的预防效果与安全性。方法制定相应的检索策略,检索中国生物医学文献数据库、中国知网、维普网、万方数据、PubMed、Embase、The Cochrane Library、Web of Science电子数据库,纳入NOACs和华法林对亚洲房颤患者治疗比较的随机对照试验,提取文献相关信息,并评价纳入文献的质量。结果总共纳入24篇文献,其中包括10785例受试者。Meta分析表明,与华法林比较,NOACs能降低亚洲房颤患者脑卒中(RR=0.63,95%CI:0.52~0.76,P<0.00001)、非神经系统性血栓栓塞(RR=0.46,95%CI:0.31~0.68,P=0.0001)及大出血(RR=0.61,95%CI:0.51~0.72,P<0.00001)的发生。结论采用NOACs治疗亚洲房颤患者脑卒中、非神经系统性血栓栓塞及大出血发生率低于华法林,NOACs用于治疗亚洲房颤患者具有良好的有效性与安全性。

Objective To evaluate the clinical efficacy and safety of new oral anticoagulant(NOACs)in the prevention of stroke in Asian patients with atrial fibrillation.Methods The related randomized controlled trials(RCT)of NOACs and warfarin in the treatment of Asian patients with AF were selected from CBM,CNKI,VIP,Wanfang,PubMed,Embase,Cochrane Library,and Web of Science Data Knowledge Service Platform through computer retrieval.The relevant information from the literature were extracted and the quality of the literature were evaluated.Results 24 articles and a total of 10785 patients were included.Meta-analysis showed that compared with warfarin,NOACs can reduce the incidence of stroke(RR=0.63,95%CI:0.52~0.76,P<0.00001),non-neurological thromboembolism(RR=0.46,95%CI:0.31~0.68,P=0.0001)and major bleeding(RR=0.61,95%CI:0.51~0.72,P<0.00001)of Asian patients with AF.Conclusion The incidence of stroke,non-neurological thromboembolism and hemorrhage in patients with AF treated with NOACs was lower than that of warfarin.NOACs have good efficacy and safety in the treatment of Asian AF patients.