Dual compared with triple antithrombotics treatment effect on ischemia and bleeding in atrial fibrillation following percutaneous coronary intervention: A meta-analysis-Reference-Cited by-同舟云学术

Dual compared with triple antithrombotics treatment effect on ischemia and bleeding in atrial fibrillation following percutaneous coronary intervention: A meta-analysis

Published:2023-09-28 Issue:2 Volume:1 Page:37-48
ISSN:3005-480X
Container-title:International Journal of Clinical Medical Research
language:en
Short-container-title:IJCMR

Author:

Emad Marina,Osama Hasnaa,Rabea Hoda,Saeed Haitham

Abstract

Background: We performed a meta-analysis to evaluate the effects of dual antithrombotic treatment (DATT) including direct oral anticoagulants (OAs) versus triple antithrombotic (TAT) with vitamin K antagonist on bleeding and ischemic results in atrial fibrillation (AF) after percutaneous coronary intervention. Methods: A systematic literature search up to April 2021 was done and 5 studies included 8019 subjects with AF using antithrombotic treatment after percutaneous coronary intervention at the start of the study; 4325 of them were using DATT and 3694 were using TATs. They were reporting relationships between the effects of DATT including direct OAs versus TAT with vitamin K antagonist on bleeding and ischemic results in AF after percutaneous coronary intervention. We calculated the odds ratio (OR) with 95% confidence intervals (CIs) to assess the effects of DATT including direct OAs versus TAT with vitamin K antagonist on bleeding and ischemic results in AF after percutaneous coronary intervention using the dichotomous method with a random or fixed-effect model. <span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">Results: Dual antithrombotics <span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">had significantly lower major bleeding (OR, 0.58; 95% CI, 0.51-0.66, p<0.001), and thrombolysis in myocardial infarction major and minor bleeding (OR, 0.49; 95% CI, 0.36-0.67, p<0.001) compared to TATs in subjects with AF using antithrombotics treatment after percutaneous coronary intervention. However, antithrombotics <span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">had no significantly difference in all-cause mortality<span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;"> (OR, 1.08; 95% CI, 0.88-1.33, p=0.46), cardiovascular mortality (OR, 1.07; 95% CI, 0.83-1.38, p=0.63), myocardial infarction (OR, 1.16; 95% CI, 0.92-1.46, p=0.01), stent thrombosis (OR, 1.42; 95% CI, 0.94-2.12., p=0.09), and stroke (OR, 0.86; 95% CI, 0.59-1.25, p=0.42) compared to TATs in subjects with AF using antithrombotics treatment after percutaneous coronary intervention. Conclusions: Dual antithrombotics<span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;"> may have a lower risk of major bleeding, and thrombolysis in myocardial infarction major and minor bleeding compared to TATs in subjects with AF using antithrombotic treatment after percutaneous coronary intervention. However, antithrombotics <span style="font-size: 10.0pt; font-family: 'Arial',sans-serif; mso-ascii-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-bidi; mso-bidi-theme-font: minor-bidi;">had no significant difference in all-cause mortality, cardiovascular mortality, myocardial infarction, stent thrombosis, and stroke compared to TATs in subjects with AF using antithrombotics treatment after percutaneous coronary intervention. Furthers studies are required to validate these findings.

Publisher

Pharaoh Academy International Publishing Co., Limited

Link

https://www.pharaohacademy.com/1/2/10/pdf

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