Efficacy and safety of dabigatran perioperative anticoagulation for patients undergoing catheter ablation of nonvalvular atrial fibrillation: a Metaanalysis
Abstract：Objective To systematically evaluate the efficacy and safety of dabigatran perioperative anticoagulation for patients undergoing catheter ablation of nonvalvular atrial fibrillation. Methods We collected research literature of randomized controlled trials (RCTs) or nonRCTs about perioperative anticoagulation for patients undergoing catheter ablation of nonvalvular atrial fibrillation from databases including PubMed, EMbase, The Cochrane Library (Issue 2, 2016), CMB, CNKI, Wanfang and VIP with computer. Two evaluators independently screened literatures, extracted data and assessed the bias risk of included studies, and then performed Metaanalysis by using software of RevMan 5.3. Results A total of 23 studies involving 7 673 patients were finally enrolled in Metaanalysis. It showed no statistically significant difference in the incidence of cerebral apoplexy or transient cerebral ischemia between dabigatran and warfarin groups(OR=1.0, 95%CI：0.60-1.68, P=0.99), and so did the incidence of hemorrhoea event(OR=0.79, 95%CI：0.52-1.19, P=0.25). The incidence of minor hemorrhoea event in dabigatran group was significantly decreased than that in warfarin group(OR=0.71, 95%CI：0.57-0.87, P=0.001). Conclusion There was no significant difference in the efficacy of perioperative anticoagulation for patients undergoing catheter ablation of nonvalvular atrial fibrillation and incidence of complication of hemorrhoea between dabigatran and warfarin. For patients taking dabigatran, the incidence of complication of minor hemorrhoea is reduced if compared with those taking warfarin.
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