Comparison among multiple interventions has been realized due to the development of network meta-analysis and so far many studies have reported its implementation process. However, its results are rarely interpreted in domestic studies at present. This article interprets the results of trace plots, density plots, Brooks-Gelman-Rubin diagnosis plots, rankogram, surface under the cumulative ranking, and network plots, to provide references and assistance for further research regarding network meta-analysis.
ObjectiveTo investigate long-term outcomes of patients without warfarin anticoagulation after isolated prosthetic aortic valve replacement (AVR) and evaluate the feasibility of short-term instead of lifelong anticoagulation therapy for low-risk AVR patients. MethodsSeven patients who underwent prosthetic AVR in Guangdong General Hospital between 1996 and 1999 but discontinued warfarin anticoagulation 3 years after surgery were regularly followed up. There were 6 male and 1 female patients with their age of 25-75 (40.0±11.4) years. These patients received warfarin anticoagulation during the first 3 years after surgery but discontinued oral anticoagulant 3 years after surgery (discontinued anticoagulation group). Fifteen patients who underwent prosthetic AVR during the same period and continued warfarin anticoagulation were enrolled as the control group (continuing anticoagulation group). International normalized ratio (INR) was set between 1.8 and 2.5 during warfarin anticoagulation period in both groups. Survival rate and the incidence of severe adverse events were compared between the 2 groups. ResultsIn the discontinued anticoagulation group,1 patient was lost during follow-up. No thromboembolic event,death or prosthetic valve thrombosis was observed. All the patients were in NYHA class Ⅰ. In the continuing anticoagulation group,3 patients were lost during follow-up. Eleven patients were in NYHA class Ⅰ and 2 patients were in NYHA class Ⅱ. Severe anticoagulation-related bleeding events occurred in 3 patients with gastrointestinal bleeding. One patient died of massive outbreak of vomiting blood,and another patient had sudden death. Ten-year survival rate was 100.0% and 86.7% in the discontinued anticoagulation group and continuing anticoagulation group, respectively. ConclusionFor low-risk patients after isolated prosthetic AVR,short-term warfarin anticoagulation may be acceptable, which means warfarin is administered only in the first 3 years after surgery and discontinued 3 years after surgery.