Department of Gastroenterology, Ganzhou People's Hospital, Ganzhou, China.
Department of Cardiology, Jiangxi Provincial People's Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang, Jiangxi, China.
Clin Appl Thromb Hemost. 2024 Jan-Dec;30:10760296241274750. doi: 10.1177/10760296241274750.
Since several studies have examined the use of direct oral anticoagulants (DOACs) in treating patients with splanchnic vein thrombosis (SVT), we conducted a meta-analyses to assess the safety and efficacy of DOACs compared to vitamin K antagonists (VKAs) in this population.
We conducted a comprehensive search using the PubMed, Embase, and Cochrane Library databases until June 2024. We used odds ratios (ORs) and 95% confidence intervals (CIs) as the effect measures to compare DOACs with VKAs.
A total of 9 observational studies were included. The pooled analysis revealed that a trend towards higher complete recanalization rates with DOACs (71.4%) compared to VKAs (55.3%), though not statistically significant (OR 1.95; 95%CI 0.70 to 5.44). For SVT extension, a significant effect was observed favoring DOACs (OR 0.12; 95%CI 0.03 to 0.54). No significant differences were found in other efficacy outcomes or safety outcomes, except for major bleeding, which was significantly lower with DOACs (OR 0.27; 95%CI 0.13 to 0.56).
DOACs are superior to VKAs in SVT extension and major bleeding, suggesting that DOACs may be a favorable treatment option in the treatment of SVT.
由于多项研究已经评估了直接口服抗凝剂（DOACs）在治疗肠系膜静脉血栓形成（SVT）患者中的应用，我们进行了一项荟萃分析，以评估 DOACs 与维生素 K 拮抗剂（VKAs）在该人群中的安全性和疗效。
我们使用 PubMed、Embase 和 Cochrane 图书馆数据库进行了全面检索，检索时间截至 2024 年 6 月。我们使用比值比（OR）和 95%置信区间（CI）作为效应测量指标，比较 DOACs 与 VKAs。
共纳入 9 项观察性研究。汇总分析显示，DOACs 组完全再通率（71.4%）较 VKAs 组（55.3%）呈升高趋势，但无统计学意义（OR 1.95；95%CI 0.70 至 5.44）。对于 SVT 延伸，DOACs 具有显著优势（OR 0.12；95%CI 0.03 至 0.54）。除大出血外，其他疗效和安全性结局均无显著差异，而 DOACs 组大出血发生率显著降低（OR 0.27；95%CI 0.13 至 0.56）。
DOACs 在 SVT 延伸和大出血方面优于 VKAs，提示 DOACs 可能是 SVT 治疗的一种有利选择。
