Liver international : official journal of the International Association for the Study of the Liver · 2024
Safety of Anticoagulation When Undergoing Endoscopic Variceal Ligation: A Systematic Review and Meta-Analysis.
СтатьяСистематический обзорМетаанализПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Loo Jing Hong, Quek Joo Wei Ethan, Low Jun Teck Gerald, Tay Wei Xuan, Ang Le Shaun, Montano-Loza Aldo J, G Abraldes Juan, Wong Yu Jun
Аннотация
INTRODUCTION: The safety of continuing anticoagulation therapy during endoscopic variceal ligation (EVL) remains controversial. We performed a systematic review and meta-analysis to evaluate the safety of anticoagulation therapy in EVL.
METHODS: We systematically searched four electronic databases from their inception until 1 June 2024, for studies that evaluated anticoagulation use and risk of rebleeding among patients undergoing EVL. The primary endpoint was rebleeding after EVL. The secondary endpoints were post-banding ulcer bleeding (PBUB) and variceal eradication rate. The PROSPERO registration number is CRD42024556094.
RESULTS: A total of 5617 participants from nine studies (eight cohort studies and one randomised trial) were included. The most common type of anticoagulation is low-molecular-weight heparin, followed by warfarin and direct oral anticoagulants (DOAC). The pooled risk of rebleeding was 10.9% (95%CI: 6.3-16.5; I2 = 65.5%). Concurrent anticoagulation during EVL did not increase the risk of overall rebleeding (OR, 1.10; 95%CI: 0.85-1.42, I2 = 0%), PBUB (OR, 1.04; 95%CI, 0.48-2.24; I2 = 24%) or severe bleeding (OR, 0.94; 95%CI, 0.31-2.85; I2 = 0%). Variceal eradication rates were similar, regardless of the use of anticoagulation therapy during EVL.
CONCLUSION: Anticoagulation did not increase the risk of rebleeding in patients who underwent EVL. Since the certainty of evidence is low, these findings should be confirmed in future randomised trials.
METHODS: We systematically searched four electronic databases from their inception until 1 June 2024, for studies that evaluated anticoagulation use and risk of rebleeding among patients undergoing EVL. The primary endpoint was rebleeding after EVL. The secondary endpoints were post-banding ulcer bleeding (PBUB) and variceal eradication rate. The PROSPERO registration number is CRD42024556094.
RESULTS: A total of 5617 participants from nine studies (eight cohort studies and one randomised trial) were included. The most common type of anticoagulation is low-molecular-weight heparin, followed by warfarin and direct oral anticoagulants (DOAC). The pooled risk of rebleeding was 10.9% (95%CI: 6.3-16.5; I2 = 65.5%). Concurrent anticoagulation during EVL did not increase the risk of overall rebleeding (OR, 1.10; 95%CI: 0.85-1.42, I2 = 0%), PBUB (OR, 1.04; 95%CI, 0.48-2.24; I2 = 24%) or severe bleeding (OR, 0.94; 95%CI, 0.31-2.85; I2 = 0%). Variceal eradication rates were similar, regardless of the use of anticoagulation therapy during EVL.
CONCLUSION: Anticoagulation did not increase the risk of rebleeding in patients who underwent EVL. Since the certainty of evidence is low, these findings should be confirmed in future randomised trials.