Cardiovascular Department, the Second Affiliated Hospital of Nanchang University, Jiangxi, China.
Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom.
Clin Appl Thromb Hemost. 2019 Jan-Dec;25:1076029619885188. doi: 10.1177/1076029619885188.
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.
尚无直接比较非维生素 K 拮抗剂口服抗凝剂 (NOAC) 相互之间的头对头试验。进行了一项网络荟萃分析 (NMA)，以检查亚洲非瓣膜性心房颤动 (NVAF) 患者中 NOAC 之间的间接比较。使用 STATA 15.0 和 ADDIS 1.16.8 软件进行统计分析。应用优势比和 95%可信区间来评估终点。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，阿哌沙班在中风或全身性栓塞、任何原因导致的死亡、大出血和颅内出血 (ICH) 情况下的等级概率分别为 0.47、0.49、0.42 和 0.51。对于心肌梗死的情况，利伐沙班的等级概率为 0.40。这项 NMA 间接比较了亚洲 NVAF 患者中主要疗效和安全性终点的 NOAC 之间的比较，等级概率分析表明，阿哌沙班在中风或全身性栓塞、任何原因导致的死亡和 ICH 方面可能表现最佳；利伐沙班可能在心肌梗死方面表现最佳。
