系统评价以华法林为对照的利伐沙班治疗中国人群房颤合并冠心病行经皮冠脉介入术后的有效性和安全性

Efficacy and Safety of Rivaroxaban versus Warfarin in the Treatment of Atrial Fibrillation with Coronary Heart Disease after Percutaneous Coronary Intervention in Chinese Population:a Systematic Review

目的系统评价以华法林为对照的利伐沙班治疗中国人群房颤合并冠心病行经皮冠脉介入术后的有效性和安全性。方法通过计算机检索FMRS外文医学信息资源检索平台、中国医院知识总库、万方数据库、维普网等,选择以华法林为对照的利伐沙班治疗中国人群房颤合并冠心病行经皮冠脉介入术后的随机对照试验。用stata MP 16.0软件进行统计分析。结果共纳入8个随机对照试验,合计931例患者。Meta分析结果显示利伐沙班组预防MACCE的疗效与华法林组相比无统计学差异;在发生总出血事件风险方面,利伐沙班组低于华法林组,两组相比统计学差异有意义;利伐沙班组与华法林组发生大出血事件的风险仍然相当,差异无统计学意义。结论利伐沙班组与华法林组疗效相当,在发生总出血事件风险方面,利伐沙班组低于华法林组,两组发生大出血事件的风险相当。由于本评价纳入的研究及患者例数均较少,因此本次研究结论有待于将来能有更多大样本、高质量的研究加以验证。

OBJECTIVE To systematically evaluate the efficacy and safety of rivaroxaban compared with warfarin in the treatment of patients with atrial fibrillation and coronary heart disease after percutaneous coronary intervention(PCI).METHODS Through computer retrieval of FMRS foreign medical information resource retrieval platform,China general hospital knowledge database,Wanfang database,vip.com,the randomized controlled trials of rivaroxaban in the treatment of atrial fibrillation with coronary heart disease in Chinese population after percutaneous coronary intervention were selected.Stata MP 16.0 software was used for statistical analysis.RESULTS Eight randomized controlled trials involving 931 patients were included.Meta analysis showed that the efficacy of rivaroxaban in preventing MACCE was not significantly different from that of warfarin group;The risk of total bleeding events in rivaroxaban group was lower than that in warfarin group;There was no significant difference in the risk of massive hemorrhage between rivaroxaban and warfarin groups.CONCLUSION The curative effect of rivaroxaban is similar to that of warfarin group.The risk of total bleeding events of rivaroxaban is lower than that of warfarin group.The risk of massive bleeding events of two groups is similar.Due to the small number of studies and patients included in this evaluation,the conclusions of this study need to be verified by more large sample and high-quality studies in the future.