Indirect comparison meta-analysis of aspirin therapy after coronary surgery
Indirect comparison meta-analysis of aspirin therapy after coronary surgery
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DOI：
10.1136/bmj.327.7427.1309
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发表时间：
2003-12-06
影响因子：
105.7
通讯作者：
Large, S
中科院分区：
文献类型：
--
作者：
Lim, E;Ali, Z;Large, S
目的通过间接比较meta分析，评价冠状动脉手术后低、中剂量阿司匹林治疗的疗效。资料来源系统检索Medline、Embase、Cochrane对照试验注册、internet试验注册网站的文献。研究选择通过血管造影评估结果，并报告移植物闭塞和患者事件发生率。不包括阿司匹林作为唯一治疗或没有安慰剂对照组的试验被排除在外。评估文章的合格性和质量，并根据剂量分组。低剂量和中剂量阿司匹林对移植物闭塞的影响的估计差异是通过结合低剂量安慰剂和中剂量安慰剂的估计对数相对风险得到的。结果对于移植物闭塞，中剂量试验的相对风险降低了45%，而低剂量试验的相对风险降低了26%。中剂量试验的更大效果总结为移植物闭塞的相对风险比为0.74(95%可信区间0.52至1.06,P = 0.10)，患者事件的相对风险比为0.81（0.57至1.16,P = 0.25）。结论在冠状动脉手术后一年内，中剂量阿司匹林比低剂量阿司匹林更能有效地减少移植物闭塞。
Objectives To evaluate the efficacy of low and medium dose aspirin therapy after coronary surgery by using an indirect comparison meta-analysis.Data sources Systematic literature search of Medline, Embase, Cochrane controlled trials register, and trial register sites on the internet.Study selection Outcome was evaluated by angiography and reported as graft occlusion and rate of events in patients. Trials that did not include aspirin as the sole therapy or did not have a placebo control arm were excluded. Articles were assessed for eligibility and quality and grouped according to dosage. The estimated difference in effect of low and medium dose aspirin on graft occlusion was obtained by combining the estimated log relative risks of low dose with placebo and medium dose with placebo.Results For graft occlusion, the medium dose trials yielded a relative risk reduction of 45% compared with 26% for the low dose trials. The greater effect in the medium dose trials is summarised by a relative risk ratio of 0.74 (95% confidence interval 0.52 to 1.06; P = 0.10) for graft occlusion and 0.81 (0.57 to 1.16; P = 0.25) for events in patients.Conclusions Medium dose aspirin may more successfully reduce graft occlusion than low dose regimens within the first year after coronary surgery.