Vorapaxar 治疗动脉粥样硬化疾病有效性和安全性的 Meta 分析

摘要

Objective To system evaluate the safety and efficacy of Vorapaxar in treatment of atherosclerotic disease. Methods Retrieved on PubMed, Embase, Cochrane Central Register of Controlled Trials, CNKI database, collected ran-domized controlled trial ( RCT) about the Vorapaxar in treatment of atherosclerotic disease since the establishment of the data-basetoOctober2014.SystematicreviewwereperformedusingRevMan5.1software.Results 5RCTswereincluded,Meta-analysis showed that:using cardiac death (CV), myocardial infarction (MI) and stroke as the composite end point event rate, group Vorapaxar’s end point event rate (OR =0.87, 95%CI 0.81-0.93, P <0.01), the major adverse cardiovascu-lar events (MACCE) incidence (OR=0.89, 95%CI 0.84-0.95, P =0.000 2), CV and the incidence of MI (OR=0.87, 95%CI 0.81-0.93, P <0.01), the incidence of MI (OR=0.85, 95%CI 0.78-0.92, P <0.01) were lower than in the placebo group, the incidence of bleeding (OR=1.48, 95%CI 1.39-1.57, P <0.01) and the incidence of intracranial hemorrhage (OR=2.36, 95%CI 1.40-3.98, P =0.001) were higher than in the placebo group.Conclusion In the treat-ment of atherosclerotic disease, although the incidence of bleeding and the incidence of intracranial hemorrhage of Vorapaxar group was significantly higher than in the placebo group, but it could significantly decrease CV, MI and stroke as the compos-ite end point event rate, also decrease the incidence of MACCE, incidence of CV and MI and the incidence rate of MI.Vora-paxar can become a new choice in the treatment of atherosclerotic disease.%目的：系统评价Vorapaxar治疗动脉粥样硬化疾病的安全性和有效性。方法检索PubMed、Em-base、Cochrane Central Register of Controlled Trials、CNKI全文数据库，收集自建库以来至2014年10月公开发表的有关Vorapaxar治疗动脉粥样硬化疾病的随机对照试验（ RCT）。采用RevMan5刎．1软件进行系统评价和Meta分析。结果共纳入5项RCT，Meta分析显示：Vorapaxar组以心源性死亡（CV）、心肌梗死（MI）和卒中为复合终点事件发生率（OR＝0．87，95％CI 0．81～0．93， P ＜0．01）、主要不良心脑血管事件（ MACCE）发生率（ OR＝0．89，95％CI 0．84～0．95， P ＜0．01）、CV和MI发生率（OR＝0．87，95％CI 0．81～0．93， P ＜0．01）、MI发生率（OR＝0．85，95％CI 0．78～0．92， P ＜0．01）低于安慰剂组，而出血发生率（OR＝1．48，95％CI 1．39～1．57， P ＜0．01）以及颅内出血发生率（OR＝2．36，95％CI 1．40～3．98， P ＝0．01）高于安慰剂组。结论在治疗动脉粥样硬化疾病时，Vorapaxar虽然在出血发生率和颅内出血发生率上显著高于安慰剂组，但能显著减少CV、MI和卒中为复合终点事件发生率、MACCE发生率、CV和MI发生率及MI发生率。 Vorapaxar可成为治疗动脉粥样硬化疾病的新选择。