Table 5Clinical evidence summary: VKA and SAPT versus VKA alone in surgical valve replacement

Outcomes

No of Participants

(studies)

Follow up

Quality of the evidence (GRADE)Relative effect (95% CI)Anticipated absolute effects
Risk with VKARisk difference with VKA and SAPT (95 % CI)
All-cause mortality at ≤12 months - not measured0Not estimable
Health-related quality of life at ≤12 months - not measured0Not estimable
Major bleeding at ≤12 months - not measured0Not estimable
Minor bleeding at ≤12 months - not measured0Not estimable
Major systemic embolism or death from vascular causes at ≤12 months

89

(1 study)

⊕⊝⊝⊝

VERY LOWa,b

due to indirectness, imprecision

RR 0.49

(0.09 to 2.53)

91 per 1000

46 fewer per 1000

(from 83 fewer to 139 more)

All-cause mortality at >12 months - not measured0Not estimable
Health-related quality of life at >12 months - not measured0Not estimable
Major bleeding at >12 months - not measured0Not estimable
Minor bleeding at >12 months - not measured0Not estimable
Arterial thromboembolic events at >12 months - not measured0Not estimable
a

Downgraded by 1 increment as the evidence reported thromboembolic events/vascular mortality and did not report the protocol outcome of thromboembolic events excluding mortality

b

Downgraded by 2 increments as the confidence interval crossed both MIDs

From: Evidence review for anticoagulant and/or antiplatelet therapy for biological prosthetic valves and after valve repair

Cover of Evidence review for anticoagulant and/or antiplatelet therapy for biological prosthetic valves and after valve repair
Evidence review for anticoagulant and/or antiplatelet therapy for biological prosthetic valves and after valve repair: Heart valve disease presenting in adults: investigation and management: Evidence review J.
NICE Guideline, No. 208.
National Guideline Centre (UK).
Copyright © NICE 2021.

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