Repository logo
 
Publication

Anticoagulation therapy in patients with post-operative atrial fibrillation: systematic review with meta-analysis

2022Journal article Restricted access
Simple item page
dc.contributor.authorNeves, Inês Antunes
dc.contributor.authorMagalhaes, Andreia
dc.contributor.authorLima da Silva, Gustavo
dc.contributor.authorAlmeida, Ana G.
dc.contributor.authorBorges, Margarida
dc.contributor.authorCosta, João
dc.contributor.authorFerreira, Joaquim J
dc.contributor.authorPinto, Fausto J.
dc.contributor.authorCaldeira, Daniel
dc.date.accessioned2022-01-14T12:45:44Z
dc.date.available2022-01-14T12:45:44Z
dc.date.issued2022
dc.description© 2021 Elsevier Inc. All rights reserved.pt_PT
dc.description.abstractBackground: Post-operative atrial fibrillation (POAF) is a relevant complication after surgery. Several studies have shown that POAF has important consequences for long-term morbidity and mortality, by increasing the risk of thromboembolic events. However, the use of oral anticoagulation (OAC) is not well established in this context. Methods: We searched MEDLINE, CENTRAL, PsycInfo and Web of Science for clinical trials and observational studies evaluating anticoagulation vs. no anticoagulation in patients with POAF (after cardiac or non-cardiac surgery). Data were screened and extracted by two independent reviewers. We performed a random- effects model to estimate the pooled odds ratio (OR) with 95% Confidence Intervals (CI), and heterogeneity was evaluated by I2 statistics. The outcomes of interest were all-cause mortality, thromboembolic events, and bleeding events. Results: Overall, 10 observational retrospective studies were included: 5 studies with 203,946 cardiac surgery POAF patients, and 5 studies with 29,566 patients with POAF after non-cardiac surgery. In cardiac surgery POAF, the OAC use was associated with lower risk of thromboembolic events (OR 0.68; 95%CI 0.47-0.96, I2 = 31%; 4 studies) and the bleeding risk was significantly increased (OR 4.30; 95%CI 3.69 to 5.02, 1 study). In non-cardiac surgery POAF, OAC did not significantly reduce the risk of thromboembolic events (OR 0.71, 95%CI 0.33-1.15; I2 = 79%; 5 studies) but was associated with increased risk of bleeding (OR 1.20, 95%CI 1.10-1.32, I2 = 0%; 3 studies). Mortality was not significantly reduced in both cardiac and non-cardiac surgery POAF. Conclusion: Oral anticoagulation was associated with a lower risk of thromboembolic events in patients with POAF following cardiac surgery but not in non-cardiac surgery. Bleeding risk was increased in both settings. The confidence on pooled results is at most low, and further data, namely randomized controlled trials are necessary to derive robust conclusions.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationVascul Pharmacol. 2021 Oct 30;142:106929pt_PT
dc.identifier.doi10.1016/j.vph.2021.106929pt_PT
dc.identifier.eissn1879-3649
dc.identifier.issn1537-1891
dc.identifier.urihttp://hdl.handle.net/10451/50818
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.relation.publisherversionhttps://www.sciencedirect.com/journal/vascular-pharmacologypt_PT
dc.subjectAnticoagulantspt_PT
dc.subjectAtrial fibrillationpt_PT
dc.subjectHemorrhagept_PT
dc.subjectStrokept_PT
dc.subjectSurgerypt_PT
dc.subjectThromboembolismpt_PT
dc.titleAnticoagulation therapy in patients with post-operative atrial fibrillation: systematic review with meta-analysispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.titleVascular Pharmacologypt_PT
person.familyNameMagalhaes
person.familyNameLima da Silva
person.familyNameAlmeida
person.familyNameBorges
person.familyNameCosta
person.familyNameFerreira
person.familyNamePinto
person.familyNameCaldeira
person.givenNameAndreia
person.givenNameGustavo
person.givenNameAna Gomes de
person.givenNameMargarida
person.givenNameJoão
person.givenNameJoaquim J
person.givenNameFausto J.
person.givenNameDaniel
person.identifier480560
person.identifier1624753
person.identifier1308889
person.identifier.ciencia-idFB15-EB01-5F40
person.identifier.ciencia-id3610-3184-3042
person.identifier.ciencia-id7D15-5CD6-6159
person.identifier.ciencia-idC311-AEDD-6DBB
person.identifier.ciencia-idAA19-EC35-8D01
person.identifier.orcid0000-0002-4638-990X
person.identifier.orcid0000-0003-3138-8354
person.identifier.orcid0000-0003-0360-4363
person.identifier.orcid0000-0002-8563-6846
person.identifier.orcid0000-0002-5831-4921
person.identifier.orcid0000-0003-3950-5113
person.identifier.orcid0000-0002-8034-4529
person.identifier.orcid0000-0002-2520-5673
person.identifier.ridG-9363-2015
person.identifier.scopus-author-id55628683100
person.identifier.scopus-author-id7102828573
person.identifier.scopus-author-id55499748300
person.identifier.scopus-author-id7403252466
person.identifier.scopus-author-id7102740158
person.identifier.scopus-author-id36623384200
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication317a6483-3261-4c02-a88b-ea0f71f7ece0
relation.isAuthorOfPublication19eb513b-6abf-4171-905e-8d8c36a33c6c
relation.isAuthorOfPublication7a34cb7e-96d7-426c-ac32-346c0c0fa68c
relation.isAuthorOfPublicationa414c62c-f8d0-447e-b0bc-779588853440
relation.isAuthorOfPublication0924f405-2d3a-4914-9097-24aa639bd97f
relation.isAuthorOfPublication54d84fe7-2cbd-4ddc-bce2-0ff2bd7c4cc9
relation.isAuthorOfPublication5f44176f-69f5-482c-83cd-ab94425a6ec3
relation.isAuthorOfPublicationeba36bb8-5eb3-4ccc-88f8-bd7012d42382
relation.isAuthorOfPublication.latestForDiscoveryeba36bb8-5eb3-4ccc-88f8-bd7012d42382

Files

Original bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
Anticoagulation_therapy.pdf
Size:
1.27 MB
Format:
Adobe Portable Document Format
Download

Collections

FM-CCUL-Artigos em Revistas Internacionais
IMM - Artigos em Revistas Internacionais