动脉血栓症抗脂综合征的抗血栓治疗:一个系统的审查和网络元分析
Tanawat Attachaipanich1, Aimpat Aungsusiripong2, Pokpong Piriyakhuntorn3
1Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Frontiers in medicine
|July 3, 2023
概括
对于抗脂综合征 (APS) 患有动脉血栓症的患者,华法林加抗血小板治疗有效地预防了复发性血栓症. 直接口服抗凝剂 (DOAC) 显著增加血栓形成风险,而双重抗血小板治疗显示出潜在的.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 类风湿病学 类风湿病学
背景情况:
- 与动脉血栓形成的抗脂综合征 (APS) 为二次血栓预防提供了挑战.
- 最佳的抗血栓策略仍在争论中,需要进行比较的疗效和安全性评估.
研究的目的:
- 为了比较各种抗血栓策略的有效性和安全性,用于对患有动脉血栓症的APS患者的二次预防.
主要方法:
- 在主要数据库 (MEDLINE,EMBASE,Web of Science,CENTRAL) 进行了系统的文献搜索.
- 一个频率的随机效应网络元分析 (NMA) 包括13项研究 (719名参与者).
- 包括的治疗包括抗血小板药物,华法林,直接口服抗凝剂 (DOAC) 或组合药物.
主要成果:
- 与单一抗血小板治疗相比,华法林加抗血小板治疗显著降低了复发性整体血栓形成风险 (RR 0.41; 95% CI 0.20-0.85).
- 双重抗血小板疗法 (DAPT) 显示了一种非显著的趋势,减少了复发性动脉血栓形成 (RR 0.29;95% CI 0.08-1.07).
- DOACs显著增加了复发性动脉血栓形成风险,而不是单次抗血小板治疗 (RR 4.06;95% CI 1.33-12.40).
- 在不同策略之间没有观察到重大出血的显著差异.
结论:
- 华法林加抗血小板治疗是一种有前途的策略,用于预防动脉血栓症APS患者的复发性血栓形成.
- 双重抗血小板治疗需要进一步研究其在预防复发性动脉血栓形成方面的有效性.
- 直接口服抗凝剂 (DOACs) 应谨慎使用,因为这种人群中复发性动脉血栓形成的风险增加.
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