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Please use this identifier to cite or link to this item: http://repository.li.mahidol.ac.th/dspace/handle/123456789/51779
Title: Efficacy and safety of anticoagulation for atrial fibrillation in patients with cirrhosis: A systematic review and meta-analysis
Authors: Ronpichai Chokesuwattanaskul
Charat Thongprayoon
Tarun Bathini
Aldo Torres-Ortiz
Oisin A. O'Corragain
Kanramon Watthanasuntorn
Ploypin Lertjitbanjong
Konika Sharma
Somchai Preechawat
Patompong Ungprasert
Paul T. Kröner
Karn Wijarnpreecha
Wisit Cheungpasitporn
King Chulalongkorn Memorial Hospital, Faculty of Medicine Chulalongkorn University
Temple University Hospital
Faculty of Medicine, Siriraj Hospital, Mahidol University
University of Arizona
Mayo Clinic
University of Mississippi Medical Center
Mayo Clinic in Jacksonville, Florida
Bassett Medical Center
Keywords: Medicine
Issue Date: 1-Apr-2019
Citation: Digestive and Liver Disease. Vol.51, No.4 (2019), 489-495
Abstract: © 2018 Editrice Gastroenterologica Italiana S.r.l. Objective: The atrial fibrillation-related stroke is clearly prevented by anticoagulation treatment, however, management of anticoagulation for AF in patients with cirrhosis represents a challenge due to bleeding concerns. To address this issue, a systematic review and meta-analysis of the literature was performed. Methods: A literature search for studies reporting the incidence of AF in patients with cirrhosis was conducted using MEDLINE, EMBASE and Cochrane Database, from inception through July 2018. Results: 7 cohort studies including 19,798 patients with AF and cirrhosis were identified. The use of anticoagulation (%) among included studies ranged from 8.3% to 53.9%. Anticoagulation use for AF in patients with cirrhosis was significantly associated with a reduced risk of stroke, with a pooled HR of 0.58 (95%CI: 0.35–0.96). When compared with no anticoagulation, the use of anticoagulation was not significantly associated with a higher risk of bleeding, with a pooled HR of 1.45 (95%CI: 0.96–2.17). Compared to warfarin, the use of direct oral anticoagulants (DOACs) was associated with a lower risk of bleeding among AF patients with cirrhosis. Conclusion: Our study demonstrates that anticoagulation use for AF in patients with cirrhosis is associated with a reduced risk of stroke, without increasing significantly the risk of bleeding, when compared to those without anticoagulation.
URI: http://repository.li.mahidol.ac.th/dspace/handle/123456789/51779
metadata.dc.identifier.url: https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85059016897&origin=inward
ISSN: 18783562
15908658
Appears in Collections:Scopus 2019

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