The Efficay And Safety Of New Oral Anticoagulants In Liver Cirrhosis:a Meta Analysis

Objective:New oral anticoagulants are one of the most widely used anticoagulants in recent years.However,there were few reports about its use in cirrhotic patients.This article aimed to evaluate safety and efficacy of new oral anticoagulants used in patients with cirrhosis.Method:We searched for studies about the safety and efficacy of new oral anticoagulants in cirrhotic patients on Pubmed,Cochrane Library,EMBASE,Science Direct,CNKI,Wanfang datdbase and VIP database,according to the literature search strategy we have planned before.Then we extracted data from the studies after screening and evaluating them.Meta analysis was performed by using R3.4.4 software.Results:A total of 5 articles were included,all of which are English observational studies and no Chinese literatures.Bleeding,progression of liver cirrhosis,recurrent portal vein thrombosis,hepatic encephalopathy,hepatorenal syndrome were reported in these articles after using the new oral anticoagulants,but no fatal results occured.The total anticoagulant related complications fluctuated between 17% and 30%,and the calculated point rate is 22%(95% CI=0.05-0.54).Heterogeneity test between studies was statistically significant(P=0.83,I2=0%,95%CI=0.16-0.29).The incidence of major bleeding was 0%-12% and the combined point rate was 6%(95%CI=0.00-0.25).Heterogeneity test has statistical significance(P=0.42,I2=0%,95%CI=0.02-0.10).The thrombosis recanalization rate was 55%-56% and final point recanalization rate reached 55%(95%CI=0.46-0.64).The heterogeneity test between studies was statistically significant(P=1.0,I2=0%,95%CI=0.32-0.75).Conclusion:New oral anticoagulants may be safe and effective in patients with cirrhosis.However,due to the lack of large-scale randomized controlled trials,its accuracy still needs to be further improved.