Effect of lanthanum carbonate on the progression of coronary artery calcification in hemodialysis patients: A meta‐analysis of randomized controlled trials

2021 ◽  
Author(s):  
Jun‐Peng Xu ◽  
Rui‐Xiang Zeng ◽  
Peng‐Da Liao ◽  
Min‐Zhou Zhang
Keyword(s):  
Coronary Artery ◽  
Randomized Controlled Trials ◽  
Coronary Artery Calcification ◽  
Meta Analysis ◽  
Hemodialysis Patients ◽  
Lanthanum Carbonate ◽  
Controlled Trials ◽  
Randomized Controlled

ID: 24: BENEFITS AND RISKS OF WARFARIN WITH AND WITHOUT ASPIRIN IN PATIENTS WITH CORONARY ARTERY DISEASE OR CEREBROVASCULAR ACCIDENT: A META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS

2016 ◽  
Vol 64 (4) ◽  
pp. 934.2-934
Author(s):  
A Deshpande ◽  
K Patel ◽  
MB Rothberg ◽  
V Pasupuleti ◽  
G Alreja ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Randomized Controlled Trials ◽  
Major Bleeding ◽  
Meta Analysis ◽  
Oral Anticoagulants ◽  
Intracranial Bleeding ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Artery Disease

BackgroundPrevious studies have shown that secondary prophylaxis of non-embolic stroke remains challenging. Randomized controlled trials (RCTs) evaluating warfarin with or without aspirin to prevent stroke have yielded mixed results. We conducted a meta-analysis of RCTs to evaluate the efficacy of warfarin (with and without aspirin) in patients with coronary artery disease (CAD) or ischemic stroke/ transient ischemic attack (TIA).MethodsWe searched 6 electronic databases published from 1980–2014. RCTs reporting the benefits (reduced incidence of stroke) and risks (mortality, intracranial bleeds, major and minor bleeds) of warfarin (with and without aspirin) therapy were included. Trials were stratified by intensity of the therapeutic international normalized ratio (INR): low (INR<2), intermediate (INR 2–3) and high (INR>3). Risk ratios (RRs) were pooled using random-effects models.ResultsTwenty-five RCTs (30,939 patients) met our inclusion criteria. Intermediate intensity warfarin with aspirin compared with aspirin alone significantly reduced the risk of secondary strokes [RR 0.48, 95% confidence interval (CI) 0.29–0.80], but increased the risk of major bleeding (RR 2.54, CI 1.70–3.79); there were no significant differences in mortality (RR 1.00, CI 0.80–1.25) and intracranial bleeding (RR 3.03, CI 0.48–19.20). Intermediate intensity warfarin without aspirin compared with aspirin alone, significantly increased major bleeding (RR 2.11, CI 1.45–3.06); there were no significant differences for stroke (RR 0.84, CI 0.66–1.08), mortality (RR1.21, CI 0.90–1.63) and intracranial bleeding (RR 1.87, CI 0.94–3.70).ConclusionsUse of intermediate intensity warfarin with aspirin reduced the risk of stroke at the price of increased bleeding. Most anticoagulation increased the risk of major bleeding with no effect on mortality. Studies with oral anticoagulants with aspirin for secondary prevention should be considered.

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