Antithrombin III for critically ill patients

Afshari, Arash; Wetterselv, Jesper Brok Jørn; Møller, Ann Merete

doi:10.1002/14651858.cd005370.pub2

Cited by 47 publications

(33 citation statements)

References 73 publications

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“…The two Cochrane reviews that addressed the issue of multiplicity in some way were Afshari 2006 [25] and Perry 2008 [26]. In the first, trial sequential analysis was used in the analysis of the primary outcome.…”

Section: Resultsmentioning

confidence: 99%

Statistical Multiplicity in Systematic Reviews of Anaesthesia Interventions: A Quantification and Comparison between Cochrane and Non-Cochrane Reviews

et al. 2011

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BackgroundSystematic reviews with meta-analyses often contain many statistical tests. This multiplicity may increase the risk of type I error. Few attempts have been made to address the problem of statistical multiplicity in systematic reviews. Before the implications are properly considered, the size of the issue deserves clarification. Because of the emphasis on bias evaluation and because of the editorial processes involved, Cochrane reviews may contain more multiplicity than their non-Cochrane counterparts. This study measured the quantity of statistical multiplicity present in a population of systematic reviews and aimed to assess whether this quantity is different in Cochrane and non-Cochrane reviews.Methods/Principal FindingsWe selected all the systematic reviews published by the Cochrane Anaesthesia Review Group containing a meta-analysis and matched them with comparable non-Cochrane reviews. We counted the number of statistical tests done in each systematic review. The median number of tests overall was 10 (interquartile range (IQR) 6 to 18). The median was 12 in Cochrane and 8 in non-Cochrane reviews (difference in medians 4 (95% confidence interval (CI) 2.0–19.0). The proportion that used an assessment of risk of bias as a reason for doing extra analyses was 42% in Cochrane and 28% in non-Cochrane reviews (difference in proportions 14% (95% CI −8 to 36). The issue of multiplicity was addressed in 6% of all the reviews.Conclusion/SignificanceStatistical multiplicity in systematic reviews requires attention. We found more multiplicity in Cochrane reviews than in non-Cochrane reviews. Many of the reasons for the increase in multiplicity may well represent improved methodological approaches and greater transparency, but multiplicity may also cause an increased risk of spurious conclusions. Few systematic reviews, whether Cochrane or non-Cochrane, address the issue of multiplicity.

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Section: Resultsmentioning

confidence: 99%

Statistical Multiplicity in Systematic Reviews of Anaesthesia Interventions: A Quantification and Comparison between Cochrane and Non-Cochrane Reviews

et al. 2011

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“…It was reported that ATⅢ supplementation exhibited beneficial effects on organ function [48], protected against development of venous thromboembolism [49], and decreased mortality [49, 50] in patients with sepsis. Nevertheless, several meta-analyses have shown no significant beneficial effect of ATⅢ substitution on mortality in critically ill patients, whereas ATⅢ increased the risk of bleeding, especially in patients receiving concomitant heparin [51-53]. …”

Section: Discussionmentioning

confidence: 99%

Antithrombin Ⅲ is a Novel Predictor for Contrast Induced Nephropathy After Coronary Angiography

Kong

Yin

et al. 2018

Kidney Blood Press Res

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Background/Aims: Antithrombin Ⅲ (AT Ⅲ) is an important endogenous anticoagulant and has strong anti-inflammatory properties. Low ATⅢ activity is considered to be a predictor of poor outcomes in several conditions, including acute kidney injury after cardiac surgery. However, the association between the ATⅢ level and the occurrence of contrast induced nephropathy (CIN) has not been elucidated. In this study, our aim was to identify the potential predictive value of ATⅢ for CIN. Methods: We enrolled a total of 460 patients who underwent coronary angiography (CAG) from January 2015 to December 2016 in coronary care units (CCU). ATⅢ activity in plasma collected before CAG was measured and <75% was considered low activity according to reference values. A cross-sectional study on CIN after CAG was conducted and the risk factors were analyzed. CIN was diagnosed according to the KDIGO guideline. Results: Of these 460 patients undergoing CAG, 125 (27.17%) progressed to CIN. The incidence of CIN was significantly higher in patients with low ATⅢ activity compared to patients with normal ATⅢ activity (Pearson’s chi-squared test P=0.002). As ATⅢ activity declined, the prevalence of CIN progressively increased, with the highest value (58.8%) in patients with an ATⅢ activity <60%. Moreover, the ATⅢ activity was significantly lower in CIN patients than in non-CIN patients (84.43±16.3% vs. 92.14±13.94%, P<0.001). After multivariable analysis, ATⅢ activity <75% remained a significant independent predictor of CIN (OR 2.207,95%CI [1.29-3.777]; P=0.004) as well as baseline serum creatinine (OR 1.009,95%CI [1.001-1.016]; P=0.026). Conclusions: Patients with low ATⅢ activity had a higher risk of developing CIN after CAG. The initial ATⅢ activity may be a novel independent predictor for CIN.

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“…Clinical studies have demonstrated that the ATIII activity is considerably decreased in critically ill patient with sepsis and pancreatitis (Afshari et al, 2008). Our study also found that ATIII activity was decreased in experimental model of CIN.…”

Section: Discussionmentioning

confidence: 99%

Antithrombin III Protects Against Contrast-Induced Nephropathy

Cheng

Yin

et al. 2017

EBioMedicine

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We previously reported that insufficiency of antithrombin III (ATIII), the major anti-coagulation molecule in vivo, exacerbated renal ischemia-reperfusion injury in animal models and possibly humans. In the present study, we investigated the relationship between ATIII level and contrast induced nephropathy (CIN) in patients and examined therapeutic effect of ATIII on CIN in Sprague-Dawley rats. Patients with low ATIII activity presented a higher incidence of acute kidney injury (AKI) following coronary angiography. ATIII (500 μg/kg) was intravenously injected before or after the induction of AKI in rats. Our data demonstrated ATIII significantly attenuated the elevation of serum creatinine, blood urea nitrogen, and renal histological injury. The beneficial effects of ATIII were accompanied by diminished renal inflammatory response, oxidative stress, cell apoptosis and improved renal blood flow in rats. In conclusion, ATIII appears to attenuate CIN through inhibiting inflammation, oxidative stress, apoptosis and improving renal blood flow. ATIII administration may represent a promising strategy for the prevention and treatment of contrast-induced AKI.

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Antithrombin III for critically ill patients

Cited by 47 publications

References 73 publications

Statistical Multiplicity in Systematic Reviews of Anaesthesia Interventions: A Quantification and Comparison between Cochrane and Non-Cochrane Reviews

Statistical Multiplicity in Systematic Reviews of Anaesthesia Interventions: A Quantification and Comparison between Cochrane and Non-Cochrane Reviews

Antithrombin Ⅲ is a Novel Predictor for Contrast Induced Nephropathy After Coronary Angiography

Antithrombin III Protects Against Contrast-Induced Nephropathy

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