Scolaris Content Display Scolaris Content Display

降低引发腹主动脉瘤患者死亡率和心血管事件血管危险因素的药物治疗

Appendices

Appendix 1. CENTRAL search strategy

#1

MESH DESCRIPTOR Aortic Aneurysm EXPLODE ALL TREES

559

#2

((aort* near3 (balloon* or dilat* or bulg* or rupture or expan*))):TI,AB,KY

438

#3

(aneury* near3 (abdominal or thoraco*)):TI,AB,KY

460

#4

AAA*:TI,AB,KY

693

#5

MESH DESCRIPTOR Vascular Surgical Procedures

523

#6

(vascular near3 surg*):TI,AB,KY

1408

#7

(infrarenal near3 surg*):TI,AB,KY

30

#8

(noncardiac near3 surg*):TI,AB,KY

175

#9

(non‐cardiac near3 surg*):TI,AB,KY

122

#10

#1 OR #2 OR #3 OR #4 OR #5 OR #6 OR #7 OR #8 OR #9

2969

#11

indobufen

81

#12

MESH DESCRIPTOR Platelet Aggregation Inhibitors EXPLODE ALL TREES

8224

#13

MESH DESCRIPTOR Phosphodiesterase Inhibitors EXPLODE ALL TREES

5416

#14

MESH DESCRIPTOR Tetrazoles

1790

#15

(antiplatelet* or anti‐platelet* or antiaggreg* or anti‐aggreg*):TI,AB,KY

2881

#16

(((platelet or thromboxane or thrombocyte or cyclooxygenase or cyclo‐oxygenase or phosphodiesterase or fibrinogen or PAR‐1) near3 (antagonist or inhibitor))):TI,AB,KY

2178

#17

((gp* or glycoprotein* or protease or P2Y12 or TXA2) near3 inhibit*):TI,AB,KY

2957

#18

thienopyridine:TI,AB,KY

230

#19

(ticlopidine or Ticlid):TI,AB,KY

1665

#20

(clopidogrel or Plavix):TI,AB,KY

2634

#21

(Prasugrel or Effient or Efient or Prasita):TI,AB,KY

374

#22

(ticagrelor or AZD6140 or Brilinta):TI,AB,KY

278

#23

(elinogrel or PRT060128 or PRT‐060128):TI,AB,KY

8

#24

(cangrelor or AR‐C6993* or ARC6993*):TI,AB,KY

40

#25

(SCH530348 or SCH‐530348):TI,AB,KY

16

#26

E5555:TI,AB,KY

5

#27

(terutroban or Triplion):TI,AB,KY

14

#28

(aspirin* or nitroaspirin or ASA):TI,AB,KY

16259

#29

(acetylsalicylic acid):TI,AB,KY

4352

#30

(acetyl salicylic acid*):TI,AB,KY

102

#31

(triflusal or disgren):TI,AB,KY

95

#32

(Cilostazol or Pletal or Pletaal):TI,AB,KY

436

#33

(dipyridamol* or Persantine):TI,AB,KY

1103

#34

(OPC‐13013 or OPC13013):TI,AB,KY

5

#35

(picotamide or picotinamide):TI,AB,KY

41

#36

satigrel:TI,AB,KY

3

#37

vorapaxar:TI,AB,KY

63

#38

indobufen:TI,AB,KY

81

#39

MESH DESCRIPTOR Antihypertensive Agents EXPLODE ALL TREES

22578

#40

MESH DESCRIPTOR Adrenergic beta‐Antagonists EXPLODE ALL TREES

9426

#41

MESH DESCRIPTOR Angiotensin‐Converting Enzyme Inhibitors EXPLODE ALL TREES

5527

#42

MESH DESCRIPTOR Diuretics EXPLODE ALL TREES

5678

#43

MESH DESCRIPTOR Calcium Channel Blockers EXPLODE ALL TREES

7947

#44

(antihypertensi* or anti‐hypertensi*):TI,AB,KY

13540

#45

(calcium near3 (antag* or block*)):TI,AB,KY

6255

#46

(amlodipin* or diltiazem or diltiazam or felodipin*):TI,AB,KY

4362

#47

(nicardipin* or nifedipin* or nimodipin*):TI,AB,KY

4603

#48

(nisoldipin* or nitrendipin* or verapamil):TI,AB,KY

2736

#49

diureti*:TI,AB,KY

6368

#50

(angiotensin near3 inhibitor*):TI,AB,KY

5765

#51

(alacepril or altiopril or benazepril or captopril or ceronapril or cilazapril or delapril or derapril ):TI,AB,KY

2804

#52

(enalapril or fosinopril or idapril or imidapril or lisinopril ):TI,AB,KY

3648

#53

(moexipril or moveltipril or pentopril ):TI,AB,KY

38

#54

(perindopril or quinapril ):TI,AB,KY

1045

#55

(ramipril or spirapril or temocapril or trandolapril or zofenopril):TI,AB,KY

1351

#56

(ACE next inhibitor*):TI,AB,KY

2565

#57

(adrenergic near3 (antagonist* or block*)):TI,AB,KY

8604

#58

(betablocker* or beta‐blocker*):TI,AB,KY

4445

#59

(acebutolol or atenolol or Tenormin ):TI,AB,KY

3213

#60

(alprenolol or betaxolol or bisoprolol or bupranolol ):TI,AB,KY

1153

#61

(carvedilol or Coreg or carteolol or celiprolol ):TI,AB,KY

1218

#62

(esmolol or labetalol ):TI,AB,KY

1068

#63

(metoprolol or nadolol or nebivolol ):TI,AB,KY

3101

#64

(oxprenolol or penbutolol or pindolol ):TI,AB,KY

1239

#65

(practolol or propranolol or timolol):TI,AB,KY

6192

#66

*artan:TI,AB,KY

4870

#67

*sartan:TI,AB,KY

4854

#68

*dipine:TI,AB,KY

8436

#69

*olol:TI,AB,KY

13831

#70

*alol:TI,AB,KY

1150

#71

(bumetanide or ethacrynic acid or furosemide or torsemide):TI,AB,KY

1967

#72

*thiazide:TI,AB,KY

4110

#73

epitizide:TI,AB,KY

2

#74

(indapamide or chlorthalidone or metolazone):TI,AB,KY

1055

#75

(amiloride or triamterene or spironolactone):TI,AB,KY

1768

#76

MESH DESCRIPTOR Anticholesteremic Agents EXPLODE ALL TREES

5458

#77

*statin:TI,AB,KY

11508

#78

meglutol:TI,AB,KY

2

#79

mevacor:TI,AB,KY

9

#80

pravachol:TI,AB,KY

5

#81

lescol:TI,AB,KY

47

#82

lipitor*:TI,AB,KY

23

#83

cholestyramine:TI,AB,KY

392

#84

(lipid next lowering):TI,AB,KY

2280

#85

(cholesterol next lowering):TI,AB,KY

1182

#86

colestipol:TI,AB,KY

152

#87

gemfibrozil:TI,AB,KY

461

#88

clofibrate:TI,AB,KY

314

#89

(nicotinic NEXT acid):TI,AB,KY

513

#90

ezetimibe:TI,AB,KY

698

#91

MESH DESCRIPTOR Fish Oils EXPLODE ALL TREES

2431

#92

MESH DESCRIPTOR Fatty Acids, Omega‐3 EXPLODE ALL TREES

2153

#93

(fatty next acid*):TI,AB,KY

10298

#94

(omega near2 acid*):TI,AB,KY

1840

#95

(*eicosapentanoic or docosahexanoic or docosapentanoic or alpha‐linolenic):TI,AB,KY

424

#96

(*eicosapentaen* or icosapentaenoic or docosahexaeno*):TI,AB,KY

2165

#97

(fish near2 oil*):TI,AB,KY

1698

#98

(cod near2 oil):TI,AB,KY

58

#99

MESH DESCRIPTOR Antioxidants EXPLODE ALL TREES

11258

#100

(antioxidant* or anti‐oxidant*):TI,AB,KY

6756

#101

#11 or #12 or #13 or #14 or #15 or #16 or #17 or #18 or #19 or #20 or #21 or #22 or #23 or #24 or #25 or #26 or #27 or #28 or #29 or #30 or #31 or #32 or #33 or #34 or #35 or #36 or #37 or #38 or #39 or #40 or #41 or #42 or #43 or #44 or #45 or #46 or #47 or #48 or #49 or #50 or #51 or #52 or #53 or #54 or #55 or #56 or #57 or #58 or #59 or #60 or #61 or #62 or #63 or #64 or #65 or #66 or #67 or #68 or #69 or #70 or #71 or #72 or #73 or #74 or #75 or #76 or #77 or #78 or #79 or #80 or #81 or #82 or #83 or #84 or #85 or #86 or #87 or #88 or #89 or #90 or #91 or #92 or #93 or #94 or #95 or #96 or #97 or #98 or #99 or #100

114007

#102

#10 and #101

522

#103

30/04/2013 TO 29/02/2016:DL

245401

#104

#102 AND #103

137

Appendix 2. Trials registries seaches

World Health Organization International Clinical Trials Registry Platform

27 new records found for abdominal aneurysm

ClinicalTrials.gov

109 new studies found for abdominal aneurysm

ISRCTN Register

10 new results for abdominal aneurysm

Study flow diagram.
Figuras y tablas -
Figure 1

Study flow diagram.

Ir a la figura de la revisiónAbrir en una pestaña nueva

'Risk of bias' summary: review authors' judgements about each 'Risk of bias' item for each included study.
Figuras y tablas -
Figure 2

'Risk of bias' summary: review authors' judgements about each 'Risk of bias' item for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Metoprolol versus placebo, Outcome 1 All‐cause mortality, 30 days.
Figuras y tablas -
Analysis 1.1

Comparison 1 Metoprolol versus placebo, Outcome 1 All‐cause mortality, 30 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Metoprolol versus placebo, Outcome 2 Cardiovascular death, 30 days.
Figuras y tablas -
Analysis 1.2

Comparison 1 Metoprolol versus placebo, Outcome 2 Cardiovascular death, 30 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Metoprolol versus placebo, Outcome 3 AAA‐related death, 30 days.
Figuras y tablas -
Analysis 1.3

Comparison 1 Metoprolol versus placebo, Outcome 3 AAA‐related death, 30 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Metoprolol versus placebo, Outcome 4 Nonfatal cardiovascular event, 30 days.
Figuras y tablas -
Analysis 1.4

Comparison 1 Metoprolol versus placebo, Outcome 4 Nonfatal cardiovascular event, 30 days.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Metoprolol versus placebo, Outcome 5 All‐cause mortality, 6 months.
Figuras y tablas -
Analysis 1.5

Comparison 1 Metoprolol versus placebo, Outcome 5 All‐cause mortality, 6 months.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Metoprolol versus placebo, Outcome 6 Cardiovascular death, 6 months.
Figuras y tablas -
Analysis 1.6

Comparison 1 Metoprolol versus placebo, Outcome 6 Cardiovascular death, 6 months.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Comparison 1 Metoprolol versus placebo, Outcome 7 Nonfatal cardiovascular event, 6 months.
Figuras y tablas -
Analysis 1.7

Comparison 1 Metoprolol versus placebo, Outcome 7 Nonfatal cardiovascular event, 6 months.

Ir a la figura de la revisiónAbrir en una pestaña nueva
Summary of findings for the main comparison. Metoprolol compared to placebo for reducing mortality and cardiovascular events in patients with abdominal aortic aneurysm

Metoprolol compared to placebo for reducing mortality and cardiovascular events in patients with abdominal aortic aneurysm (AAA)

Patient or population: patients of any age with AAA less than 30 mm in diameter
Setting: hospital
Intervention: metoprolol
Comparison: placebo

Outcomes

Anticipated absolute effects* (95% CI)

Relative effect
(95% CI)

Number of participants
(studies)

Quality of the evidence
(GRADE)

Comments

Risk with placebo

Risk with metoprolol

All‐cause mortality, 30 days1

Study population

OR 0.17
(0.02 to 1.41)

227
(1 RCT)

⊕⊕⊝⊝
low2

—

52 per 1000

9 per 1000
(1 to 71)

Cardiovascular death, 30 days3

Study population

OR 0.20
(0.02 to 1.76)

227
(1 RCT)

⊕⊕⊝⊝
low2

—

43 per 1000

9 per 1000
(1 to 73)

AAA‐related death, 30 days4

Study population

OR 1.05
(0.06 to 16.92)

227
(1 RCT)

⊕⊕⊝⊝
low2

—

9 per 1000

9 per 1000
(1 to 128)

Nonfatal cardiovascular event, 30 days5

Study population

OR 1.44
(0.58 to 3.57)

227
(1 RCT)

⊕⊕⊝⊝
low2

—

78 per 1000

108 per 1000
(47 to 231)

All‐cause mortality, 6 months1

Study population

OR 0.71
(0.26 to 1.95)

227
(1 RCT)

⊕⊕⊝⊝
low2

—

86 per 1000

63 per 1000
(24 to 155)

Cardiovascular death, 6 months3

Study population

OR 0.73
(0.23 to 2.39)

227
(1 RCT)

⊕⊕⊝⊝
low2

—

60 per 1000

45 per 1000
(15 to 133)

AAA‐related death, 6 months4

See comments

See comments

See comments

See comments

The incidence of AAA‐related death was not measured at six months.

Nonfatal cardiovascular event, 6 months5

Study population

OR 1.41
(0.59 to 3.35)

227
(1 RCT)

⊕⊕⊝⊝
low2

—

86 per 1000

117 per 1000
(53 to 240)

*The risk with placebo was the average risk in the placebo group (i.e. the number of participants with events divided by total number of participants of the placebo group included in the meta‐analysis). The risk in the metoprolol group (and its 95% CI) is based on the assumed risk in the placebo group and the relative effect of the intervention (and its 95% CI).

Abbreviations: AAA: abdominal aortic aneurysm; CI: confidence interval; MI: myocardial infarction; OR: odds ratio; RCT: randomised controlled trial

GRADE Working Group grades of evidence
High quality: we are very confident that the true effect lies close to that of the estimate of the effect
Moderate quality: we are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different
Low quality: our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect
Very low quality: we have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

1Death from all causes.
2Quality of evidence downgraded to low for imprecision due to low number of events, small sample size and wide CIs.
3Fatal MI, fatal stroke and other vascular deaths.
4Death due to abdominal aortic aneurysm.
5Nonfatal MI, nonfatal stroke, or transient ischaemic attack.

Figuras y tablas -
Summary of findings for the main comparison. Metoprolol compared to placebo for reducing mortality and cardiovascular events in patients with abdominal aortic aneurysm
Ir a la tabla de la revisión
Comparison 1. Metoprolol versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 All‐cause mortality, 30 days Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Cardiovascular death, 30 days Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

3 AAA‐related death, 30 days Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4 Nonfatal cardiovascular event, 30 days Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

5 All‐cause mortality, 6 months Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

6 Cardiovascular death, 6 months Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected

7 Nonfatal cardiovascular event, 6 months Show forest plot

1

Odds Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 1. Metoprolol versus placebo
Ir a la tabla de la revisión