The Efficacy And Safety Of Oral Coagulation Actor Xa Inhibitor In Acute Coronary Yndrome: A Meta-analysis

Objective: A meta-analysis of randomized controlled trials wasperformed to evaluate the efficacy and safety of oral direct Xa inhibitor inconjunction with anti-platelet drugs in the treatment of acute coronarysyndrome.Methods：All five Randomised controlled trials (RCTs) of Oral directXa inhibitor in acute coronary syndromes were included，including indirectoral Factor Xa inhibitors with antiplatelet drugs versus placebo withantiplatelet drugs. To evaluate the effect of these agents on MACE and majorbleeding complication.Results: RCTs were included in the study (n=27158) and nopublication bias were detected among these trials. As compared to placebowith single antiplatelet (aspirin) drugs group, Xa inhibitors group reducedthe incidence of MACE (RR=0.77,95%CI=[0.60-0.98]) but increasedclinically bleeding (RR=2.16,95%CI=[1.26-4.06]). Xa inhibitors groupdeceased the incidence of MACE (RR=0.85,95%CI=[0.78-0.93]) butincreased bleeding complications (RR=2.13,95%CI=[1.95-2.32]) compared to placebo with double antiplatelet drugs (Aspirin andclopidogrel).Conclusions: In patients with a recent acute coronary syndrome, therisk of cardiovascular events was modest reduce among those receivingoral anti-Xa inhibitors but substantial increase in bleeding.