医学新知2024，Vol.34Issue(2)：157-166,10.DOI:10.12173/j.issn.1004-5511.202302010
心房颤动相关急性缺血性脑卒中早期抗凝治疗有效性和安全性的Meta分析
Efficacy and safety of early anticoagulation in patients with acute ischemic stroke due to atrial fibrillation:a Meta-analysis
摘要
Abstract
Objective To evaluate the efficacy and safety of early use of new oral anticoagulants(≤3 days)in patients with acute ischemic stroke(AIS)due to atrial fibrillation(AF).Method After systematic retrieval of CNKI,WanFang Data,VIP,PubMed,The Cochrane Library and Embase database,clinical studies on early anticoagulation therapy for AF-related AIS patients were screened.The search was conducted from the time of database construction to November 4,2022,while the references were searched manually.Literature screening,data extraction and quality assessment were performed independently by 2 investigators.Meta-analysis was performed using RevMan 5.4 software,and the combined dichotomous effect sizes were expressed as relative risk(RR)and 95%confidence interval(CI).Result A total of 2 randomized controlled trials and 5 non-randomized controlled trials including 2 226 patients were included,and the analysis suggested that early anticoagulation treatment(≤3 days)was similar to delayed anticoagulation(＞3 days)in terms of total ischemic events[RR=1.04,95%CI(0.67,1.61),P=0.88],recurrent ischemic strokes or transient ischemic attack[RR=0.88,95%CI(0.58,1.34),P=0.56],major bleeding[RR=1.24,95%CI(0.59,2.62),P=0.56],and symptomatic intracerebral haemorrhage[RR=0.98,95%CI(0.44,2.17),P=0.96].In terms of total cerebral hemorrhages,the incidence was lower than in the delayed anticoagulation group.Conclusion Anticoagulation started early after the occurrence of atrial fibrillation related ischemic stroke is similar to delayed anticoagulation in terms of effectiveness,and does not increase the risk of bleeding in patients.关键词
心房颤动/急性缺血性脑卒中/新型口服抗凝药/Meta分析/早期Key words
Atrial fibrillation/Acute ischemic stroke/New oral anticoagulants/Meta-analysis/Early引用本文复制引用
王运香,齐旭慧,蔡焕焕,鲁志兵..心房颤动相关急性缺血性脑卒中早期抗凝治疗有效性和安全性的Meta分析[J].医学新知,2024,34(2):157-166,10.基金项目
湖北省自然科学基金创新群体项目(2021CFA051) （2021CFA051）
