Department of Cardiovascular, Guang'anmen Hospital, China Academy of Chinese Medical Sciences.
Emergency Department, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China.
Medicine (Baltimore). 2021 Jan 8;100(1):e24280. doi: 10.1097/MD.0000000000024280.
Atrial fibrillation (AF) is one of the most common arrhythmias, and is high relative to cardiovascular morbidity and mortality. AF-related complications and treatment costs bring about huge health burden, therefore the prevention recurrence of AF is imperative. "Upstream therapy" refers to the use of non-antiarrhythmic drugs (non-AADs) that modify the atrial substrate or target-specific mechanisms of AF to prevent the occurrence or recurrence of the arrhythmia. RAAS Blockers, aldosterone receptor antagonists and statins have an effect on preventing recurrence of atrial fibrillation. This protocol is designed for systematic review and network meta-analysis, which will assess comparative effects and safety of various non-antiarrhythmic drugs in preventing recurrence of atrial fibrillation.
The Cochrane Library, MEDLINE, EMBASE, ClinicalTrials.gov will be searched from inception to Aug 31, 2020 to identify relevant studies. The Cochrane "Risk of bias" tool will be used to assess the methodological quality of eligible studies. The pair-wise meta-analysis will be performed by STATA 14.0 software. The network meta-analysis will be implemented in a Bayesian framework using Win BUGS 1.4.3 and the package "gemtc" V.0.8.1 of R-3.6.2 software. The network plots will be drawn using STATA 14.0 software. A comparison-adjusted funnel plot will be used to assess the publication bias using STATA 14.0 software. Quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.
The results of this network meta-analysis will determine the preventive effect and rank ordering of these interventions for recurrence of AF. The report will follow the PRISMA checklist for network meta-analysis.
This network meta-analysis will provide comprehensive evidence-based information in clinical practice.
INPLASY202090004.
心房颤动（AF）是最常见的心律失常之一，与心血管发病率和死亡率相比偏高。AF 相关并发症和治疗费用带来了巨大的健康负担，因此预防 AF 复发至关重要。“上游治疗”是指使用非抗心律失常药物（非-AAD）来改变心房基质或针对 AF 的特定机制，以预防心律失常的发生或复发。肾素-血管紧张素-醛固酮系统阻滞剂、醛固酮受体拮抗剂和他汀类药物对预防心房颤动复发有效果。本方案旨在进行系统评价和网络荟萃分析，以评估各种非抗心律失常药物预防心房颤动复发的比较效果和安全性。
从建库至 2020 年 8 月 31 日，我们将在 Cochrane 图书馆、MEDLINE、EMBASE 和 ClinicalTrials.gov 中搜索相关研究。我们将使用 Cochrane“偏倚风险”工具评估合格研究的方法学质量。STATA 14.0 软件将用于进行两两荟萃分析。贝叶斯框架将在 Win BUGS 1.4.3 和 R-3.6.2 软件的“gemtc”V.0.8.1 包中实施网络荟萃分析。STATA 14.0 软件将用于绘制网络图。使用 STATA 14.0 软件进行比较调整的漏斗图，以评估发表偏倚。使用推荐评估、制定与评价（GRADE）方法评估证据质量。
该网络荟萃分析的结果将确定这些干预措施对 AF 复发的预防效果和排序。报告将遵循网络荟萃分析的 PRISMA 清单。
该网络荟萃分析将为临床实践提供全面的循证信息。
INPLASY 注册号：INPLASY202090004。
