Vasculocardiology Deparment, Cangzhou Central Hospital, No. 16 Xinhua Road, Yunhe Qu, Cangzhou 061000, China.
Biomed Res Int. 2020 Jul 11;2020:2679539. doi: 10.1155/2020/2679539. eCollection 2020.
This meta-analysis aimed at exploring the predictive value of CHADS-VASc score for the left atrial thrombus (LAT) or left atrial spontaneous echo contrast (LASEC) in patients with nonvalvular atrial fibrillation (NVAF).
PubMed, Embase, Web of Science, ScienceDirect, Cochrane Library, and Chinese core journals of the CNKI and Wanfang databases were searched to identify all the relevant papers that were published up to January 2020. The data were extracted for pooled odds ratios (ORs) with 95% confidence intervals (CIs), heterogeneity, subgroup, publication bias, and sensitivity analysis.
Overall, 15 studies containing 6223 patients with NVAF were enrolled. All studies were evaluated for LAT, and 12 studies were evaluated for LASEC. The pooled analysis using a random-effects model showed that a high CHADS-VASc score was related with LAT/LASEC (pooled OR = 1.59, 95% CI: 1.35-1.88, < 0.001) with high heterogeneity ( = 76.9%, < 0.001) and LAT (pooled OR = 1.83, 95% CI: 1.44-2.33, < 0.001) with high heterogeneity ( = 79.4%, < 0.001). The subgroup analysis demonstrated that the sample size may be the main source of heterogeneity. Although the Begg's funnel plot based on 15 studies for LAT/LASEC ( = 0.029) and 12 studies for LAT ( = 0.046) indicated the presence of publication bias among the included studies, the trim-and-fill method verified the stability of the pooled outcomes. In addition, sensitivity analysis indicated that all effects were stable.
The results of this meta-analysis showed that the CHADS-VASc score is related with LAT and LASEC in patients with NVAF. However, more studies are warranted to address this issue.
本荟萃分析旨在探讨 CHADS-VASc 评分对非瓣膜性心房颤动（NVAF）患者左心房血栓（LAT）或左心房自发性回声对比（LASEC）的预测价值。
检索 PubMed、Embase、Web of Science、ScienceDirect、Cochrane 图书馆以及中国知网和万方数据库的中文核心期刊，以确定截至 2020 年 1 月发表的所有相关文献。提取数据进行汇总优势比（ORs）和 95%置信区间（CIs）、异质性、亚组、发表偏倚和敏感性分析。
共有 15 项包含 6223 例 NVAF 患者的研究纳入本荟萃分析。所有研究均评估了 LAT，12 项研究评估了 LASEC。使用随机效应模型的汇总分析显示，高 CHADS-VASc 评分与 LAT/LASEC 相关（汇总 OR = 1.59，95%CI：1.35-1.88，<0.001），且具有高度异质性（I² = 76.9%，<0.001），与 LAT 相关（汇总 OR = 1.83，95%CI：1.44-2.33，<0.001），且具有高度异质性（I² = 79.4%，<0.001）。亚组分析表明，样本量可能是异质性的主要来源。尽管基于 15 项 LAT/LASEC 研究的 Begg 漏斗图（I² = 0.029）和基于 12 项 LAT 研究的 Begg 漏斗图（I² = 0.046）表明纳入研究存在发表偏倚，但填充和删失法验证了汇总结果的稳定性。此外，敏感性分析表明所有效应均稳定。
本荟萃分析结果表明，CHADS-VASc 评分与 NVAF 患者的 LAT 和 LASEC 相关。然而，需要更多的研究来解决这个问题。
