Predicting Thromboembolic and Bleeding Event Risk in Patients with Non-Valvular Atrial Fibrillation: A Systematic Review.
Predicting Thromboembolic and Bleeding Event Risk in Patients with Non-Valvular Atrial Fibrillation: A Systematic Review.
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DOI：
10.1055/s-0038-1675400
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发表时间：
2018-12
影响因子：
6.7
通讯作者：
Sanders GD
中科院分区：
文献类型：
--
作者：
Borre ED;Goode A;Raitz G;Shah B;Lowenstern A;Chatterjee R;Sharan L;Allen LaPointe NM;Yapa R;Davis JK;Lallinger K;Schmidt R;Kosinski A;Al-Khatib SM;Sanders GD
房颤(房颤)是一种常见的心律失常，增加了中风的风险。降低中风风险的药物治疗包括抗凝，这可能会增加某些患者的出血风险。在为房颤患者确定预防中风的最佳治疗方法时，临床医生使用具有各种临床、影像和患者特征的工具来权衡中风风险和治疗相关出血风险。回顾已发表的文献并总结可用于预测房颤患者卒中和出血的风险分层工具。我们检索了在2000年1月1日至2018年2月14日期间发表的PubMed®、Embase®和Cochrane数据库中的英语研究。两位评论家筛选了研究的引文，这些研究检查了预测房颤患者血栓栓子和出血风险的工具。提取了有关研究设计、患者特征、干预措施、结果、质量和适用性的数据。61项研究与血栓栓塞症风险预测有关，38项研究与出血风险预测相关。数据表明，CHADS2、CHA2DS2-VASc和ABC风险评分预测血栓栓塞症风险的证据最好(证据强度中等，各评分的预测能力有限)，出血的风险评分预测出血风险的证据最好(证据强度中等)。研究在方法学和研究对象、背景、干预措施和结果分析上是不同的。CHADS2、CHA2DS2-VASc和ABC卒中对卒中事件的预测最好，出血对出血风险的预测最好。未来的研究应该确定成像工具和生物标记物在提高风险预测工具的准确性方面的作用。以患者为中心的结果研究所(PROSPERO#CRD42017069999)
Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of stroke. Medical therapy for decreasing stroke risk involves anticoagulation, which may increase bleeding risk for certain patients. In determining optimal therapy for stroke prevention for patients with AF, clinicians use tools with various clinical, imaging, and patient characteristics to weigh stroke risk against therapy-associated bleeding risk. Review published literature and summarize available risk stratification tools for stroke and bleeding prediction in patients with AF. We searched for English-language studies in PubMed®, Embase®, and the Cochrane Database of Systematic Reviews published between January 1, 2000, and February 14, 2018. Two reviewers screened citations for studies that examined tools for predicting thromboembolic and bleeding risks in patients with AF. Data regarding study design, patient characteristics, interventions, outcomes, quality and applicability were extracted. 61 studies were relevant to predicting thromboembolic risk and 38 to predicting bleeding risk. Data suggest that CHADS2, CHA2DS2-VASc, and ABC risk scores have the best evidence predicting thromboembolic risk (moderate strength of evidence for limited prediction ability of each score) and that HAS-BLED has the best evidence for predicting bleeding risk (moderate strength of evidence). Studies were heterogeneous in methodology and populations of interest, setting, interventions, and outcomes analyzed. CHADS2, CHA2DS2-VASc, and ABC stroke have the best prediction for stroke events, and HAS-BLED provides the best prediction for bleeding risk. Future studies should define the role of imaging tools and biomarkers in enhancing the accuracy of risk prediction tools. Patient-Centered Outcomes Research Institute (PROSPERO #CRD42017069999)
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影响因子：
2.1
作者：
An, JaeJin;Niu, Fang;Aranda, Gustavus Jr
通讯作者：
Aranda, Gustavus Jr
影响因子：
5.9
作者：
Abraham, JoEllyn M.;Larson, Joseph;Wassertheil-Smoller, Sylvia
通讯作者：
Wassertheil-Smoller, Sylvia
影响因子：
3.3
作者：
Asuncion Esteve-Pastor, Maria;Garcia-Fernandez, Amaya;Marin, Francisco
通讯作者：
Marin, Francisco
DOI：
10.1136/heartjnl-2016-309910
发表时间：
2017-02
期刊：
Heart (British Cardiac Society)
影响因子：
--
作者：
Allan V;Banerjee A;Shah AD;Patel R;Denaxas S;Casas JP;Hemingway H
通讯作者：
Hemingway H
影响因子：
24
作者：
Chao, Tze-Fan;Lip, Gregory Y. H.;Chen, Shih-Ann
通讯作者：
Chen, Shih-Ann