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Background
Evidence on the efficacy and safety of anticoagulation in preventing stroke and thromboembolic events in people with thyrotoxic atrial fibrillation is scarce.
Objective
We evaluated the efficacy and safety of anticoagulation in people with thyrotoxic atrial fibrillation.
Methods
Our study protocol was published in the International Prospective Register of Systematic Reviews (registration no. CRD42020222782). Four databases and two systematic review registers were searched through 25 November 2020 for interventional and observational studies comparing anticoagulation therapy with active comparators, placebo, or no treatment in people with thyrotoxic atrial fibrillation. Random-effects meta-analysis and sensitivity analysis were performed. Quality of evidence was described using the GRADE framework.
Results
In the study, 23,145 records were retrieved. One randomized controlled trial and eight cohort studies were ultimately included. Effect estimates on the efficacy and safety of anticoagulation were extracted. Meta-analysis using the inverse variance and random-effects methods was conducted on four cohort studies with 3443 participants and 277 events. Anticoagulation in people with thyrotoxic atrial fibrillation reduced the risk of ischemic stroke and systemic thromboembolism by 3% (95% CI: 1–6%). Warfarin may prevent ischemic stroke in people with thyrotoxic atrial fibrillation if the CHA2DS2-VASc score exceeds 1 and when atrial fibrillation persists beyond 7 days. Direct oral anticoagulants may be associated with fewer bleeding events than warfarin.
Conclusions
Anticoagulation prevents ischemic stroke and systemic thromboembolism in people with thyrotoxic atrial fibrillation. Direct oral anticoagulants may be associated with fewer bleeding events.
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Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Division of Endocrinology and Metabolism, Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
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Cardiovascular Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
Taipei Heart Institute, Taipei Medical University, Taipei, Taiwan
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of serum lipids. However, the baseline TG and TC levels of the study cohort were <150 and <200 mg/dL, respectively ( 20 ). Similarly, in a Norwegian double-blind, randomized, placebo-controlled trial including a total of 251 healthy adults aged 18
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-2045(1370362-0 ) 13 Rinke A Müller HH Schade-Brittinger C Klose KJ Barth P Wied M Mayer C Aminossadati B Pape UF Bläker M , et al . Placebo-controlled, double-blind, prospective, randomized study on the effect of octreotide LAR in the control of
Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Department of Pediatric Neuro-Oncology, Prinses Máxima Centrum, Utrecht, The Netherlands
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Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands
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Otte C Hinkelmann K Moritz S Yassouridis A Jahn H Wiedemann K Kellner M . Modulation of the mineralocorticoid receptor as add-on treatment in depression: a randomized, double-blind, placebo-controlled proof-of-concept study . Journal of
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remains to be determined. Furthermore, the effect of statin on IDOL should ideally be evaluated in a randomized placebo-controlled manner. However, it would be unethical to withhold treatment in patients with FH. Our study cannot address the question of
Department of Clinical Biochemistry, Hospital of South West Jutland, Esbjerg, Denmark
Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
Department of Internal Medicine, Lillebaelt Hospital, Kolding, Denmark
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Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark
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Department of Clinical Biochemistry, Hospital of South West Jutland, Esbjerg, Denmark
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Department of Clinical Biochemistry, Hospital of South West Jutland, Esbjerg, Denmark
Department of Haematology, Erasmus MC, University Medical Centre Rotterdam, Rotterdam, The Netherlands
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Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
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Department of Clinical Biochemistry, Hospital of South West Jutland, Esbjerg, Denmark
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– 926 . ( https://doi.org/10.1016/j.soard.2018.03.022 ) 18 Host C Bojesen A Erlandsen M Groth KA Kritstensen K Jurik AG Birkebaek NH Gravholt CH . A placebo-controlled randomized study with testosterone in Klinefelter syndrome
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Department of Cardiology, Yanbian University Hospital, Yanji, China
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-016-0386-5 ) 37 Kumarathurai P Anholm C Larsen BS Olsen RH Madsbad S Kristiansen O Nielsen OW Haugaard SB & Sajadieh A . Effects of liraglutide on heart rate and heart rate variability: a randomized, double-blind, placebo-controlled crossover
