The Efficacy of Non–Vitamin K Antagonist Oral Anticoagulants in the Prevention of Left Atrial Thrombus in Patients With Atrial Fibrillation Compared With Vitamin K Antagonists: A Meta-Analysis

医学 维生素K拮抗剂 心房颤动 优势比 内科学 荟萃分析 血栓 随机对照试验 维生素k 华法林 置信区间 心脏病学
作者
Jun Liu,Yiping Wu,Shurui Li,Lihong Song,Chengdong Hu
出处
期刊:Heart Surgery Forum [Carden Jennings Publishing Co.]
卷期号:23 (6): E733-E739 被引量:1
标识
DOI:10.1532/hsf.3203
摘要

Background: There is still a paucity of data on the efficacy of non–vitamin K antagonist oral anticoagulants (NOACs) in the prevention of left atrial thrombus (LAT) formation before cardioversion or catheter ablation. To assess the efficacy of NOACs in the prevention of LAT in patients with non-valvular atrial fibrillation (NVAF) compared with vitamin K antagonists (VKAs), we conducted a meta-analysis. Methods: We searched PubMed, Embase, and the Cochrane Library databases. For meta-analysis, dichotomous variables were analyzed by using the odds ratios (OR) computed using the Mantel Haenszel method (random models). All results were reported with 95% confidence intervals (CI). Results: A total of 13 studies (one randomized controlled investigation and 12 observational studies) were included in the meta-analysis. There was no statistically significant difference between the NOACs and VKAs groups with respect to the odds of LAT/LAAT formations (OR 0.79; 95% CI: 0.52-1.21; P = .29; (I2 = 14%). Conclusions: NOACs were as effective as VKAs in the prevention of LAT/LAAT formation in patients with NVAF. Though patients on NOACs therapy showed a lower incidence of LAT/LAAT formation compared with VKAs, it was not significant (P = .29).
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