https://scholars.lib.ntu.edu.tw/handle/123456789/630188
標題: | Head-to-head comparison between left atrial appendage occlusion and non-vitamin K oral anticoagulants in non-valvular atrial fibrillation patients: A systematic review and meta-analysis study | 作者: | Waranugraha, Yoga LIAN-YU LIN CHIA-TI TSAI |
關鍵字: | Left atrial appendage occlusion;Non-valvular atrial fibrillation;Non-vitamin K oral anticoagulants | 公開日期: | 10-二月-2023 | 起(迄)頁: | Online ahead of print. | 來源出版物: | Trends in cardiovascular medicine | 摘要: | Left atrial appendage occlusion (LAAO) was found to be non-inferior to warfarin. In non-valvular atrial fibrillation (AF), there is still a scarcity of data comparing LAAO versus non-vitamin K oral anticoagulants (NOACs). Our purpose was to compare the clinical benefits between LAAO and NOACs in non-valvular AF patients. The patient, intervention, comparison, and outcome principles were used to develop the research question in this systematic review and meta-analysis. Literature searches were conducted in online scientific databases such as ProQuest, PubMed, and ScienceDirect. All important information was extracted. The random-effect model was applied to estimate all pooled effects. The Mantel-Haenszel statistical method was used to determine the pooled risk ratio (RR) and 95% confidence interval (CI). A total of 4411 participants from 5 studies were involved. LAAO significantly decreased the cardiovascular mortality risk compared to NOACs (RR = 0.56; 95% CI = 0.42 to 0.75; p <0.01). Major bleeding risk in the LAAO group was significantly lower than in the NOACs group (RR = 0.66; RR = 0.53 to 0.82; p <0.01). A significantly lower risk of major bleeding or non-major bleeding in the patients receiving LAAO than NOACs was also observed in this meta-analysis (RR = 0.66; 95% CI = 0.54 to 0.81; p <0.01). LAAO was superior to the NOACs in reducing cardiovascular mortality, major bleeding, and major or non-major bleeding risks in non-valvular AF patients. In high-risk thromboembolism and bleeding patients, LAAO can be considered first as a long-term treatment strategy. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/630188 | ISSN: | 10501738 | DOI: | 10.1016/j.tcm.2023.02.002 |
顯示於: | 醫學系 |
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