A Meta-analysis Of The Efficacy And Safety Of Warfarin VS.Aspirin In The Of Thrombosis Prevention In Patients With Heart Failure And Sinus Rhythm

Objective: To explore the optimal therapy of preventing thrombosis for patients with sinus rhythm and heart failure.Methods: Electronic database searching was performed on Pubmed Embase?CNKI?VIP to collect random controlled trials about warfarin vs aspirin for patients with heart failure and sinus rhythm.The statistical analysis was performed using RevMan 5.3 software.Results:6 RCTs,3662 patients(aspirin=1838,warfarin=1824).The risk of the death from any cause(RR=1.01,95%CI 0.89~1.14,P=0.88)?myocardial infarction(RR=1.09,95%CI 0.74~1.61,P=0.67)?hospitalization for heart failure(RR=0.90,95%CI 0.64~1.26,P=0.60)?CNS bleeding(RR=1.34,95%CI 0.63~2.82,P=0.45)?adverse gastrointestinal reactions(RR=1.10,95%CI 0.23~5.30,P=0.91)were not significantly different between these two kinds of therapy.However,the warfarin group demonstrated a lower incidence of ischemic stroke(RR=0.49,95%CI 0.33~0.73,P=0.0005)but a higher incidence of major bleeding(RR=1.93,95%CI 1.38~2.68,P=0.0001)and minor bleeding(RR=1.37,95%CI 1.11~1.68,P=0.003)than asprin.Conclusions: In the prevention of thrombosis for the patients with heart failure and sinus rhythm,compared with aspirin,warfarin is less in ischemic stroke but more common in the minor bleeding and major bleeding events.