Meta AnalysisID 5597
维生素K拮抗剂对比直接口服抗凝药用于经导管主动脉瓣置换术后心房颤动的有效性和安全性：Meta分析
CRD42023393282
Should post-TAVI patients with an indication for OAC be treated with DOAC or Vitamin K antagonists?
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Record Fields
Scalar fields from the final meta_analysis record.
- Meta Analysis Id
- 5597
- Evidence Id
- 14155
- Core Evidence Id
- 14155
- Source Meta Analysis Id
- 5580
- Herb2 Meta Analysis Id
- HBMA005580
- Crd Id
- CRD42023393282
- Title
- Efficacy and Safety of Vitamin K Antagonists versus Direct Oral Anticoagulants for Atrial Fibrillation after Transcatheter Aortic Valve Replacement: A Meta-Analysis
- Review Question
- Should post-TAVI patients with an indication for OAC be treated with DOAC or Vitamin K antagonists?
- Study Type Included
- Randomized controlled trials, prospective studies
- Condition Being Studied
- Almost all patients with AF undergoing TAVI have an indication for OAC based on the CHADS-VASc score. Current American College of Cardiology/American Heart Association and European Society of Cardiology AF guidelines recommend DOACs over VKA in DOAC-eligible patients (class Ia) 6, 7. However, the optimal agent choice in post-TAVI patients, whether DOAC or oral VKA, remains unknown. Observational studies 8 9 and meta-analyses 10, 11 have shown conflicting data. The recent ATLANTIS trial demonstrated that apixaban was not superior to standard of care (VKA if indication for OAC; antiplatelet therapy if no indication for OAC) in post-TAVI patients although incidence of valve leaflet thrombosis was lower in the apixaban group. With the availability of new randomized data, we performed an updated meta-analysis of all available studies comparing DOAC versus oral VKA in patients undergoing TAVI with concomitant AF and indication for OAC
- Participant
- Inclusion criteria: We included studies that 1) compared oral VKA and DOAC after TAVI in patients with AF; and 2) provided data on all-cause mortality, major/life threatening bleeding, and stroke. The study was included in the meta-analysis if it reported at least one of the outcomes. Exclusion criteria: Children Studies without control group
- Animal
- Human Disease Modelled
- Intervention
- DOAC versus Vitamin K antagonists DOAC versus standard of care including antiplatelet agents
- Comparator Control
- No treatment Standard of care
- Main Outcome
- 28-day mortality Stroke Major/life-threatening bleeding Measures of effect Odds Ratio
- Outcome Measure
- Additional Outcome
- Not applicable
- Study Method
- Meta-analysis, Systematic review
- Keyword
- Anticoagulants; Atrial Fibrillation; Fibrinolytic Agents; Humans; Transcatheter Aortic Valve Replacement; Vitamins
- Contact
- VIJAIRAM SELVARAJ [email protected]
- Organisational Affiliation
- Miriam Hospital/Lifespan Group
- Funding Source
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- United States of America
- Review Stage
- Review Ongoing
- First Submission Date
- 2023-01-20
- Registration Date
- 2023-01-30
- Anticipated Start Date
- 2023-01-02
- Anticipated Completion Date
- 2023-02-20
- Title Cn
- 维生素K拮抗剂对比直接口服抗凝药用于经导管主动脉瓣置换术后心房颤动的有效性和安全性：Meta分析
- Title En
- Efficacy and Safety of Vitamin K Antagonists versus Direct Oral Anticoagulants for Atrial Fibrillation after Transcatheter Aortic Valve Replacement: A Meta-Analysis
- Bilingual Status
- complete