Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Asians With Nonvalvular Atrial Fibrillation: A Network Meta-Analysis
Efficacy and Safety of Non-Vitamin K Antagonist Oral Anticoagulants in Asians With Nonvalvular Atrial Fibrillation: A Network Meta-Analysis
复制标题
非维生素 K 拮抗剂口服抗凝药对亚洲非瓣膜性房颤患者的疗效和安全性：网络荟萃分析
DOI：
10.1177/1076029619885188
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发表时间：
2019-11-07
影响因子：
2.9
通讯作者：
Hong, Kui
中科院分区：
文献类型：
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作者：
Xiong, Qinmei;Wang, Cen;Hong, Kui
很少有直接比较非维生素K拮抗剂口服抗凝剂（NOAC）的头对头试验。进行了一项网络荟萃分析（NMA），以检查亚洲非瓣膜性房颤（NVAF）患者NOAC之间的间接比较。采用STATA 15.0和阿迪斯1.16.8软件进行统计学分析。采用95%可信区间的比值比评价终点。治疗等级概率用于了解哪些干预措施更有效和安全，总等级概率为1。在我们的NMA中，阿哌沙班在卒中或全身性栓塞、全因死亡、大出血和颅内出血（ICH）病例中的秩概率分别为0.47、0.49、0.42和0.51。对于心肌梗死病例，利伐沙班的秩概率为0.40。该NMA间接比较了亚洲NVAF患者中NOAC的主要疗效和安全性终点，秩概率分析显示，阿哌沙班可能在卒中或全身性栓塞、全因死亡和ICH病例中表现最佳;利伐沙班可能在心肌梗死中表现最佳。
There are few head-to-head trials directly comparing non-vitamin K antagonist oral anticoagulants (NOACs) against one other. A network meta-analysis (NMA) was performed to examine the indirect comparisons among NOACs in Asians with nonvalvular atrial fibrillation (NVAF). STATA 15.0 and ADDIS 1.16.8 softwares were used to perform the statistical analysis. Odds ratios with 95% credible intervals were applied to evaluate the end points. The probabilities of treatment rank were used to understand which interventions are more effective and safe, and the total rank probability was 1. In our NMA, the rank probabilities of apixaban in the case of stroke or systemic embolism, death from any cause, major bleeding, and intracranial hemorrhage (ICH) were 0.47, 0.49, 0.42, and 0.51, respectively. For cases of myocardial infarction, the rank probabilities of rivaroxaban were 0.40. This NMA indirectly compares the main efficacy and safety end points among NOACs in Asians with NVAF, and the rank probability analysis showed that apixaban likely performs best in cases of stroke or systemic embolism, death from any cause, and ICH; rivaroxaban may have the best performance for myocardial infarction.