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Meta-Analysis
. 2020 Jun 26;20(1):307.
doi: 10.1186/s12872-020-01582-2.

Efficacy and safety outcomes in novel oral anticoagulants versus vitamin-K antagonist on post-TAVI patients: a meta-analysis

Hongbin Liang  1 , Qiyu He  2   3 , Qiuxia Zhang  1 , Xuewei Liu  1 , Kai Cui  1 , Guojun Chen  1 , Jiancheng Xiu  4
Affiliations
Meta-Analysis

Efficacy and safety outcomes in novel oral anticoagulants versus vitamin-K antagonist on post-TAVI patients: a meta-analysis

Hongbin Liang et al. BMC Cardiovasc Disord. .

Abstract

Background: Transcatheter aortic valve implantation (TAVI) has been a favored option for the patient who suffered from symptomatic aortic stenosis. However, the efficacy and safety outcomes in novel oral anticoagulants (NOACs) versus Vitamin-K antagonist (VKA) for post-TAVI patients are still controversial. This meta-analysis aims at comparing the clinical outcome and safety of NOACs and VKA in the patients after receiving TAVI.

Method: We searched literature articles in all reachable databases, and observational study as well as randomized controlled trial would be included in order to perform a comprehensive analysis. All-cause mortality, major or life-threatening bleeding, disabling or nondisabling stroke were main pooled outcome measures. Subgroup analysis and meta-regression were adopted to explore heterogeneity. Assessment of bias was performed under the suggestion of Cochrane's Collaboration Tool.

Results: We collected 3841 non-duplicate citations from PubMed, Embase, Cochrane and ClinicalTrials.gov, and eventually 7 studies were included for this meta-analysis. As a result, VKA showed priority against NOACs in the field of anti-thromboembolism (4435 participants, RR:1.44, 95% CI: 1.05 to 1.99, I2 = 0%, P = 0.02).

Conclusion: With corroborative analysis of severe complications, VKA is shown to be more protective on post-TAVI patients in disabling or nondisabling stroke scenario but not in mortality or bleeding event.

Keywords: Meta-analysis; NOACs; TAVI; VKA.

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Conflict of interest statement

All authors have no conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of this meta-analysis
Fig. 2
Fig. 2
Funnel-plot of assessing publication bias. a Funnel-plot of all-cause mortality. b Funnel-plot of bleeding. c Funnel-plot of disabling or non-disabling stroke. d Funnel-plot of combined end-point
Fig. 3
Fig. 3
Forrest-plot of each individual outcome. a Forrest-plot of all-cause mortality. b Forrest-plot of bleeding. c Forrest-plot of disabling or non-disabling stroke
Fig. 4
Fig. 4
Forrest-plot of stroke occurred in first 30 days after TAVI
Fig. 5
Fig. 5
Forrest-plot of combined end-points
See this image and copyright information in PMC

References

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