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【文摘发布】心房颤动患者抗凝血治疗可降低卒
Author:Robert G. Hart, MD; Lesly A. Pearce, MS; and Maria I. Aguilar, MD
Resource:Annals of Internal Medicine,19 June 2007 | Volume 146 Issue 12 | Pages 857-867
ABSTRACT
Background: Atrial fibrillation is a strong independent risk factor for stroke.
Purpose: To characterize the efficacy and safety of antithrombotic agents for stroke prevention in patients who have atrial fibrillation, adding 13 recent randomized trials to a previous meta-analysis.
Data Sources: Randomized trials identified by using the Cochrane Stroke Group search strategy, 1966 to March 2007, unrestricted by language.
Study Selection: All published randomized trials with a mean follow-up of 3 months or longer that tested antithrombotic agents in patients who have nonvalvular atrial fibrillation.
Data Extraction: Two coauthors independently extracted information regarding interventions; participants; and occurrences of ischemic and hemorrhagic stroke, major extracranial bleeding, and death.
Data Synthesis: Twenty-nine trials included 28 044 participants (mean age, 71 years; mean follow-up, 1.5 years). Compared with the control, adjusted-dose warfarin (6 trials, 2900 participants) and antiplatelet agents (8 trials, 4876 participants) reduced stroke by 64% (95% CI, 49% to 74%) and 22% (CI, 6% to 35%), respectively. Adjusted-dose warfarin was substantially more efficacious than antiplatelet therapy (relative risk reduction, 39% [CI, 22% to 52%]) (12 trials, 12 963 participants). Other randomized comparisons were inconclusive. Absolute increases in major extracranial hemorrhage were small (≤0.3% per year) on the basis of meta-analysis.
Limitation: Methodological features and quality varied substantially and often were incompletely reported.
Conclusions: Adjusted-dose warfarin and antiplatelet agents reduce stroke by approximately 60% and by approximately 20%, respectively, in patients who have atrial fibrillation. Warfarin is substantially more efficacious (by approximately 40%) than antiplatelet therapy. Absolute increases in major extracranial hemorrhage associated with antithrombotic therapy in participants from the trials included in this meta-analysis were less than the absolute reductions in stroke. Judicious use of antithrombotic therapy importantly reduces stroke for most patients who have atrial fibrillation. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Title: Meta-analysis: Antithrombotic Therapy to Prevent Stroke in Patients Who Have Nonvalvular Atrial Fibrillation
题目：荟萃分析：非瓣膜房颤患者抗凝治疗可降低卒中风险
Resource:Annals of Internal Medicine,19 June 2007 | Volume 146 Issue 12 | Pages 857-867
资源：国内医学年鉴，12期146册857～867页，2007－06－19
ABSTRACT摘要
Background: Atrial fibrillation is a strong independent risk factor for stroke.
背景：心房纤颤是卒中的一个完全独立的危险因素
Purpose: To characterize the efficacy and safety of antithrombotic agents for stroke prevention in patients who have atrial fibrillation, adding 13 recent randomized trials to a previous meta-analysis.
目的：通过先前的荟萃分析中的13个最近的随机化试验，说明抗凝药物对于房颤患者预防卒中的有效性和安全性
Data Sources: Randomized trials identified by using the Cochrane Stroke Group search strategy, 1966 to March 2007, unrestricted by language.
数据源：来源于1966年至2007年3月之间Cochrane卒中组搜索策略的随机试验，语言不限
Study Selection: All published randomized trials with a mean follow-up of 3 months or longer that tested antithrombotic agents in patients who have nonvalvular atrial fibrillation.
研究选择：所有已发表的，平均跟踪三个月或更长时间的研究抗血栓治疗对非瓣膜房颤患者作用的随机试验
Data Extraction: Two coauthors independently extracted information regarding interventions; participants; and occurrences of ischemic and hemorrhagic stroke, major extracranial bleeding, and death.
数据分析：两名试验人员独立地分析了关于干预者与受试者的信息，以及缺血、出血性卒中、较严重的颅外出血和死亡的事件
Data Synthesis: Twenty-nine trials included 28 044 participants (mean age, 71 years; mean follow-up, 1.5 years). Compared with the control, adjusted-dose warfarin (6 trials, 2900 participants) and antiplatelet agents (8 trials, 4876 participants) reduced stroke by 64% (95% CI, 49% to 74%) and 22% (CI, 6% to 35%), respectively.
数据综合：涵盖28044名受试者的29个试验（平均年龄71岁，平均跟踪时间1.5年）。与对照组相比，采用适量的华法林（6个试验，2900名受试者）和抗血小板药物（8个试验，4876名受试者）抗凝治疗的患者卒中发生率分别减少了64％和22％。
Adjusted-dose warfarin was substantially more efficacious than antiplatelet therapy (relative risk reduction, 39% [CI, 22% to 52%]) (12 trials, 12 963 participants). Other randomized comparisons were inconclusive. Absolute increases in major extracranial hemorrhage were small (≤0.3% per year) on the basis of meta-analysis.
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作者:admin@医学,生命科学 2011-03-11 17:12
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