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1.
ACS Macro Lett ; 13(7): 882-888, 2024 Jul 16.
Artículo en Inglés | MEDLINE | ID: mdl-38953383

RESUMEN

We report a "grafting to" method for stably grafting high-molecular-weight polymer brushes on both active and inert surfaces using tadpole-like single-chain particles (TSCPs) with an interactive "head" as grafting units. The TSCPs can be efficiently synthesized through intrachain cross-linking one block of a diblock copolymer; the "head" is the intrachain cross-linked single-chain particle, and the "tail" is a linear polymer chain that has a contour length up to micrometers. When grafted to a surface, the "head", integrating numerous interacting groups, can synergize multiple weak interactions with the surface, thereby enabling stable grafting of the "tail" on both active and traditionally challenging inert surfaces. Because the structural parameters and composition of the "heads" and "tails" can be separately adjusted over a wide range, the interactivity of the "heads" with the surface and properties of the brushes can be controlled orthogonally, accomplishing surface brushes that cannot be achieved by existing methods.

2.
Angew Chem Int Ed Engl ; : e202410383, 2024 Jun 23.
Artículo en Inglés | MEDLINE | ID: mdl-38922734

RESUMEN

Hydrogel actuators with complex 3D initial shapes show numerous important applications, but it remains challenging to fabricate such actuators. This article describes a polyelectrolyte-based strategy for modulating small-scale internal stresses within hydrogels to construct complex actuators with tailored 3D initial shapes. Introducing polyelectrolytes into precursor solutions significantly enhances the volume shrinkage of hydrogel networks during polymerization, allowing us to modulate internal stresses. Photopolymerization of these polyelectrolyte-containing solutions through a mask produces mechanically strong hydrogel sheets with large patterned internal stresses. Consequently, these hydrogel sheets attain complex 3D initial shapes at equilibrium, in contrast to the planar initial configuration of 2D actuators. We demonstrate that these 3D actuators can reversibly transform into other 3D shapes (i.e., 3D-to-3D shape transformations) in response to external stimuli. Additionally, we develop a predictive model based on the Flory-Rehner theory to analyze the polyelectrolyte-mediated shrinking behaviors of hydrogel networks during polymerization, allowing precise modulation of shrinkage and internal stress. This polyelectrolyte-boosted shrinking mechanism paves a route to the fabrication of high-performance 3D hydrogel actuators.

3.
Soft Matter ; 20(27): 5271-5272, 2024 Jul 10.
Artículo en Inglés | MEDLINE | ID: mdl-38939922
4.
J Coll Physicians Surg Pak ; 34(5): 568-572, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38720218

RESUMEN

OBJECTIVE: To explore the impact of the Geko neuromuscular stimulator on preoperative preparation in patients with ankle fractures. STUDY DESIGN: Quasi-experiment study. Place and Duration of the Study: Department of Foot and Ankle Surgery and Department of Orthopaedics, Beijing Tongren Hospital, Capital Medical University, Beijing, China, between December 2020 and 2021. METHODOLOGY: This quasi-experiment study included patients with ankle fractures treated with Geko neuromuscular stimulator before surgical fixation. The primary outcome was limb swelling at 24, 48, and 72 hours (h) after admission, and the secondary outcomes were pain according to visual analogue scale (VAS) at 12, 24, and 48 hours after admission, preoperative waiting time, and comfort 4 and 72 h after admission. RESULTS: A total of 60 patients were included in the study; 30 in the conventional treatment group (mean age 41.16 ± 2.01 years) and 30 in the Geko group (mean age 40.22 ± 2.68 years). The limb swelling in patients was significantly different between the Geko and conventional treatment groups (p = 0.004). Besides, the swelling values at 48 (p < 0.001) and 72 (p < 0.001) hours were significantly lower than those at 24 hours. The pain in patients was significantly different between the Geko and conventional treatment groups (p = 0.007). Besides, the swelling values at 24 (p < 0.001) and 48 (p < 0.001) hours are significantly lower than those at 24 hours. Comfort was significantly higher at 4 h (69.54 ± 2.18 vs. 67.22 ± 3.14, p = 0.002) and 72 h [(88.50 (84.00 - 94.00) vs. 82.14 ± 3.08, p < 0.001)] after admission. The preoperative waiting time (3.52 ± 1.8 vs. 5.15 ± 2.1 hours, p = 0.002) was significantly shorter in the Geko group. CONCLUSION: The Geko neuromuscular stimulator is a useful option for preoperative preparation in patients with ankle fractures to reduce local swelling and pain and improve patients' comfort. KEY WORDS: Ankle fractures, Lower extremity, Neuromuscular stimulator, Peroneal nerve, Pain.


Asunto(s)
Fracturas de Tobillo , Cuidados Preoperatorios , Humanos , Masculino , Femenino , Fracturas de Tobillo/cirugía , Adulto , Cuidados Preoperatorios/métodos , Dimensión del Dolor , Fijación Interna de Fracturas/métodos , Persona de Mediana Edad , Terapia por Estimulación Eléctrica/métodos , Resultado del Tratamiento , China
5.
J Am Chem Soc ; 146(20): 14225-14234, 2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38717289

RESUMEN

The linear assembly of nanocrystals (NCs) with orientational order presents a significant challenge in the field of colloidal assembly. This study presents an efficient strategy for assembling oleic acid (OAH)-capped, faceted rare earth NCs─such as nanorods, nanoplates, and nanodumbbells─into flexible chain-like superstructures. Remarkably, these NC chains exhibit a high degree of particle orientation even with an interparticle distance reaching up to 15 nm. Central to this oriented assembly method is the facet-selective adsorption of low-molecular-weight polyethylene glycol (PEG), such as PEG-400 (Mn = 400), onto specific facets of NCs. This regioselectivity is achieved by exploiting the lower binding affinity of OAH ligands on the (100) facets of rare earth NCs, enabling facet-specific ligand displacement and subsequent PEG attachment. By adjusting the solvent polarity, the linear assembly of NCs is induced by the solvophobic effect, which simultaneously promotes the formation of hydrogen-bonded PEG supramolecular bridges. These supramolecular bridges effectively connect NCs and exhibit sufficient robustness to maintain the structural integrity of the chains, despite the large interparticle spacing. Notably, even when coassembling different types of NCs, the resulting multicomponent chains still feature highly selective facet-to-facet connections. This work not only introduces a versatile method for fabricating well-aligned linear superstructures but also provides valuable insights into the fundamental principles governing the facet-selective assembly of NCs in solution.

6.
Angew Chem Int Ed Engl ; 63(18): e202401828, 2024 Apr 24.
Artículo en Inglés | MEDLINE | ID: mdl-38403819

RESUMEN

Self-assembly of inorganic nanoparticles (NPs) is an essential tool for constructing structured materials with a wide range of applications. However, achieving ordered assembly structures with externally programmable properties in binary NP systems remains challenging. In this work, we assemble binary inorganic NPs into hierarchically pH-responsive alternating copolymer-like nanostructures in an aqueous medium by engineering the interparticle electrostatic interactions. The polymer-grafted NPs bearing opposite charges are viewed as nanoscale monomers ("nanomers"), and copolymerized into alternating nano-copolymers (ANCPs) driven by the formation of interparticle "bonds" between nanomers. The resulting ANCPs exhibit reversibly responsive "bond" length (i.e., the distance between nanomers) in response to the variation of pH in a range of ~7-10, allowing precise control over the surface plasmon resonance of ANCPs. Moreover, specific interparticle "bonds" can break up at pH≥11, leading to the dis-assembly of ANCPs into molecule-like dimers and trimers. These dimeric and trimeric structures can reassemble to form ANCPs owing to the resuming of interparticle "bonds", when the pH value of the solution changes from 11 to 7. The hierarchically responsive nanostructures may find applications in such as biosensing, optical waveguide, and electronic devices.

7.
Angew Chem Int Ed Engl ; 63(1): e202313406, 2024 Jan 02.
Artículo en Inglés | MEDLINE | ID: mdl-37801444

RESUMEN

Colloidal molecules (CMs) are precisely defined assemblies of nanoparticles (NPs) that mimic the structure of real molecules, but externally programming the precise self-assembly of CMs is still challenging. In this work, we show that the photo-induced self-assembly of complementary copolymer-capped binary NPs can be precisely controlled to form clustered ABx or linear (AB)y CMs at high yield (x is the coordination number of NP-Bs, and y is the repeating unit number of AB clusters). Under UV light irradiation, photolabile p-methoxyphenacyl groups of copolymers on NP-A*s are converted to carboxyl groups (NP-A), which react with tertiary amines of copolymers on NP-B to trigger the directional NP bonding. The x value of ABx can be precisely controlled between 1 and 3 by varying the irradiation duration and hence the amount of carboxyl groups generated on NP-As. Moreover, when NP-A* and NP-B are irradiated after mixing, the assembly process generates AB clusters or linear (AB)y structures with alternating sequence of the binary NPs. This assembly approach offers a simple yet non-invasive way to externally regulate the formation of various CMs on demand without the need of redesigning the surface chemistry of NPs for use in drug delivery, diagnostics, optoelectronics, and plasmonic devices.

8.
ACS Nano ; 17(3): 3047-3054, 2023 Feb 14.
Artículo en Inglés | MEDLINE | ID: mdl-36603151

RESUMEN

Colloidal molecules (CMs) assembled from plasmonic nanoparticles are an emerging class of building blocks for creating plasmonic materials and devices, but precise yet reversible assembly of plasmonic CMs remains a challenge. This communication describes the reversible self-assembly of binary plasmonic nanoparticles capped with complementary copolymer ligands into different CMs via halogen bonding interactions at high yield. The coordination number of the CMs is governed by the number ratio of complementary halogen donor and acceptor groups on the interacting nanoparticles. The reversibility of the halogen bonds allows for controlling the repeated formation and disassociation of the plasmonic CMs and hence their optical properties. Furthermore, the CMs can be designed to further self-assemble into complex structures in selective solvents. The precisely engineered reversible nanostructures may find applications in sensing, catalysis, and smart optoelectronic devices.

9.
ACS Nano ; 17(1): 725-734, 2023 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-36575649

RESUMEN

Plasmonic surface lattice resonances (SLRs) supported by metallic nanoparticle (NP) arrays show diverse applications including nanolasers, sensors, photocatalysis, and nonlinear optics. However, to rationally fabricate high-quality plasmonic NP arrays with ultranarrow SLR line widths over large areas remains challenging. This article describes a general approach for the efficient fabrication of centimeter-scale inorganic NP arrays with precisely controlled NP size, composition, position, and lattice geometry. This method combines the processes of solvent-assisted soft lithography and in situ site-specific NP growth to reproducibly create many replicates of NP arrays without utilizing cleanroom and specialized equipment. For demonstration, we show that Au NP arrays exhibit ultranarrow SLRs with a line width of 4 nm and a quality factor of 218 toward the theoretical limit.

10.
Soft Matter ; 19(4): 634-639, 2023 Jan 25.
Artículo en Inglés | MEDLINE | ID: mdl-36562393

RESUMEN

Plasmonic nanovesicles show broad applications in areas such as cancer theranostics and drug delivery, but the preparation of nanovesicles from shaped nanoparticles remains challenging. This article describes the vesicular self-assembly of shaped nanoparticles, such as gold nanocubes grafted with amphiphilic block copolymers, in selective solvents. The nanocubes assembled within the vesicular membranes exhibit two distinctive packing modes, namely square-like and hexagonal packing, depending on the relative dimensions of the copolymer ligands and nanocubes. The corresponding optical properties of the plasmonic nanovesicles can be tuned by varying the length of the grafted copolymers and the size of the nanocubes. This work provides guidance for the fabrication of functional plasmonic vesicles for applications in catalysis, nanomedicines and optical devices.

11.
ACS Nano ; 16(12): 21208-21215, 2022 Dec 27.
Artículo en Inglés | MEDLINE | ID: mdl-36453842

RESUMEN

The precise organization and orientation of anisotropic nanoparticles (NPs) on substrates over a large area is key to the application of NP assemblies in functional optical, electronic, and magnetic devices, but achieving such high-precision NP assembly still remains challenging. Here, we demonstrate the site-selective assembly of magnetic nanoellipsoids into large-area precisely positioned, orientationally controlled arrays via a combination of chemical patterning and magnetic manipulation. Magnetic ellipsoidal NPs are selectively positioned on predetermined chemical patterns with high fidelity through electrostatic interactions and aligned uniformly in line with an applied magnetic field. The position, orientation, and interparticle spacing of the ellipsoids can be precisely tuned by controlling the chemical patterns and magnetic field. This approach is simple to implement and can generate centimeter-scale arrays in high yield (up to 99%). The arrays exhibit collective magnetic responses that are dependent on the orientation of the ellipsoids. This work offers a tool for the fabrication of precisely engineered arrays of anisotropic NPs for applications such as metasurface and artificial spin ice.

12.
Carbohydr Polym ; 297: 119998, 2022 Dec 01.
Artículo en Inglés | MEDLINE | ID: mdl-36184164

RESUMEN

Fabricating alginate fibers of high strength and toughness remains a great challenge because of the difficulty in improving both strength and toughness simultaneously. Herein, this work reported the hierarchical assembly of sodium alginate nano-helix and its potential application as a new reinforcing unit for alginate fibers. Contributed from the hierarchical structures of α-helix, ß-sheet and tertiary helical alignment of nanofibrils, nano-helix improved the tensile strength of fibers with enhanced modulus, and prolonged elongation through unravelling the tertiary structures. Thus, the strength, elongation and toughness of alginate fibers were all enhanced by >200 %, solving the tradeoff of strength and toughness. The mechanical performance of nano-helix engineered alginate fibers is superior to present alginate fibers and even some other biomass-based fibers. The assembly of nano-helix provides a feasible reinforcing strategy for polysaccharide based materials, achieving simultaneous improvement of strength and toughness.


Asunto(s)
Alginatos , Alginatos/química , Resistencia a la Tracción
13.
Nat Commun ; 13(1): 5549, 2022 Sep 22.
Artículo en Inglés | MEDLINE | ID: mdl-36138015

RESUMEN

Colloidal liquid crystals are an emerging class of soft materials that naturally combine the unique properties of both liquid crystal molecules and colloidal particles. Chiral liquid crystal blue phases are attractive for use in fast optical displays and electrooptical devices, but the construction of blue phases is limited to a few chiral building blocks and the formation of blue phases from achiral ones is often counterintuitive. Herein we demonstrate that achiral dumbbell-shaped colloids can assemble into a rich variety of characteristic liquid crystal phases, including nematic phases with lock structures, smectic phase, and particularly experimental observation of blue phase III with double-twisted chiral columns. Phase diagrams from experiments and simulations show that the existence and stable regions of different liquid crystal phases are strongly dependent on the geometrical parameters of dumbbell-shaped colloids. This work paves a new route to the design and construction of blue phases for photonic applications.

14.
Small Methods ; 6(9): e2200545, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35869619

RESUMEN

Patchy nanoparticles (NPs) show many important applications, especially for constructing structurally complex colloidal materials, but existing synthetic strategies generate patchy NPs with limited types of symmetry. This article describes a versatile copolymer ligand-based strategy for the scalable synthesis of uniform Au-(SiO2 )x patchy NPs (x is the patch number and 1 ≤ x ≤ 5) with unusual symmetry at high yield. The hydrolysis and condensation of tetraethyl orthosilicate on block-random copolymer ligands induces the segregation of copolymers on gold NPs (AuNPs) and hence governs the structure and distribution of silica patches formed on the AuNPs. The resulting patchy NPs possess unique configurations where the silica patches are symmetrically arranged at one side of the core NP, resembling the geometry of polar small molecules. The number, size, and morphology of silica patches, as well as the spacing between the patches and the AuNP can be precisely tuned by tailoring copolymer architectures, grafting density of copolymers, and the size of AuNPs. Furthermore, it is demonstrated that the Au-(SiO2 )x patchy NPs can assemble into more complex superstructures through directional interaction between the exposed Au surfaces. This work offers new opportunities of designing next-generation complex patchy NPs for applications in such as biomedicines, self-assembly, and catalysis.

15.
Acc Chem Res ; 55(11): 1503-1513, 2022 06 07.
Artículo en Inglés | MEDLINE | ID: mdl-35576169

RESUMEN

Current interest in nanoparticle ensembles is motivated by their collective synergetic properties that are distinct from or better than those of individual nanoparticles and their bulk counterparts. These new advanced optical, electronic, magnetic, and catalytic properties can find applications in advanced nanomaterials and functional devices, if control is achieved over nanoparticle organization. Self-assembly offers a cost-efficient approach to produce ensembles of nanoparticles with well-defined and predictable structures. Nanoparticles functionalized with polymer molecules are promising building blocks for self-assembled nanostructures, due to the comparable dimensions of macromolecules and nanoparticles, the ability to synthesize polymers with various compositions, degrees of polymerization, and structures, and the ability of polymers to self-assemble in their own right. Moreover, polymer ligands can endow additional functionalities to nanoparticle assemblies, thus broadening the range of their applications.In this Account, we describe recent progress of our research groups in the development of new strategies for the self-assembly of nanoparticles tethered to macromolecules. At the beginning of our journey, we developed a new approach to patchy nanoparticles and their self-assembly. In a thermodynamically driven strategy, we used poor solvency conditions to induce homopolymer surface segregation in pinned micelles (patches). Patchy nanoparticles underwent self-assembly in a well-defined and controlled manner. Following this work, we overcame the limitation of low yield of the generation of patchy nanoparticles, by using block copolymer ligands. For block copolymer-capped nanoparticles, patch formation and self-assembly were "staged" by using distinct stimuli for each process. We expanded this work to the generation of patchy nanoparticles via dynamic exchange of block copolymer molecules between the nanoparticle surface and micelles in the solution. The scope of our work was further extended to a series of strategies that utilized the change in the configuration of block copolymer ligands during nanoparticle interactions. To this end, we explored the amphiphilicity of block copolymer-tethered nanoparticles and complementary interactions between reactive block copolymer ligands. Both approaches enabled exquisite control over directional and self-limiting self-assembly of complex hierarchical nanostructures. Next, we focused on the self-assembly of chiral nanostructures. To enable this goal, we attached chiral molecules to the surface of nanoparticles and organized these hybrid building blocks in ensembles with excellent chiroptical properties. In summary, our work enables surface engineering of polymer-capped nanoparticles and their controllable and predictable self-assembly. Future research in the field of nanoparticle self-assembly will include the development of effective characterization techniques, the synthesis of new functional polymers, and the development of environmentally responsive self-assembly of polymer-capped nanoparticles for the fabrication of nanomaterials with tailored functionalities.


Asunto(s)
Nanopartículas , Nanoestructuras , Ligandos , Micelas , Nanopartículas/química , Nanoestructuras/química , Polímeros/química
16.
Macromol Rapid Commun ; 43(14): e2200171, 2022 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-35503906

RESUMEN

Polymer-grafted hairy nanoparticles (HNPs) that combine the unique properties of inorganic nanoparticles (NPs) and polymers are attractive building blocks for the layer-by-layer assembly of functional hybrid materials, but the adsorption behaviors of HNPs on substrates remain unclear. This article describes a systematic study on the adsorption behaviors of charged polymer-grafted HNPs on oppositely charged substrates in different solvent media via a combination of experiments and simulations. It is shown in simulations that the adsorption process of HNPs is associated with the release of counterions around charged polymers on HNPs, thus resulting in a higher energy barrier of NP adsorption than bare NPs without charged polymer tethers. This energy barrier decreases with decreasing the dielectricity of solvents or ionization degree of grafted polymers or increasing ionic strength of the solution. Furthermore, the theoretical prediction is confirmed in experiments by using a model system of poly(acrylic acid)-grafted silica NPs and poly(diallyldimethylammonium chloride)-modified wafers. The work provides guidance for the electrostatic assembly of HNPs into functional hybrid composites with applications in membranes, optical devices, and biomedicines.


Asunto(s)
Nanopartículas , Polímeros , Adsorción , Nanopartículas/química , Polímeros/química , Electricidad Estática , Propiedades de Superficie
17.
ACS Nano ; 16(3): 4609-4618, 2022 Mar 22.
Artículo en Inglés | MEDLINE | ID: mdl-35166534

RESUMEN

The precise organization and orientation of plasmonic molecules on substrates is crucial to their application in functional devices but still remains a grand challenge. This article describes a bottom-up strategy to efficiently fabricate centimeter-scale superlattices of three-dimensionally oriented plasmonic dimers with highly tunable collective optical properties on substrates. The in-plane (i.e., X-Y plane) and out-of-plane (i.e., along Z-axis) orientation of the constituent plasmonic dimers can be precisely controlled by a combination of directional capillary force and supporting polymer film. Our experimental measurements and numerical simulations show that the macroscopic dimer superlattices exhibit polarization-dependent plasmon Fano resonances in air and multimodal surface lattice resonances with high quality factors in a homogeneous medium, owing to the high positional and orientational ordering of the subunits. Our strategy enables the fabrication of complex plasmonic nanostructures with precise configurations for advanced plasmonic devices such as plasmon nanolasing and metamaterials.

18.
Adv Mater ; 34(6): e2107434, 2022 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-34693571

RESUMEN

Nanomedicines have the potential to provide advanced therapeutic strategies in combating tumors. Polymer-prodrug-based nanomedicines are particularly attractive in cancer therapies owing to the maximum drug loading, prolonged blood circulation, and reduced premature leakage and side effects in comparison with conventional nanomaterials. However, the difficulty in precisely tuning the composition and drug loading of polymer-drug conjugates leads to batch-to-batch variations of the prodrugs, thus significantly restricting their clinical translation. Polyprodrug nanomedicines inherit the numerous intrinsic advantages of polymer-drug conjugates and exhibit well-controlled composition and drug loading via direct polymerization of therapeutic monomers, representing a promising nanomedicine for clinical tumor therapies. In this review, recent advances in the development of polyprodrug nanomedicines are summarized for tumor elimination. Various types of polyprodrug nanomedicines and the corresponding properties are first summarized. The unique advantages of polyprodrug nanomedicines and their key roles in various tumor therapies are further highlighted. Finally, current challenges and the perspectives on future research of polyprodrug nanomedicines are discussed.


Asunto(s)
Antineoplásicos , Neoplasias , Profármacos , Antineoplásicos/uso terapéutico , Sistemas de Liberación de Medicamentos , Humanos , Nanomedicina , Neoplasias/tratamiento farmacológico , Polímeros/uso terapéutico , Profármacos/uso terapéutico
19.
Small ; 18(2): e2104440, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34738711

RESUMEN

The intellectualization and complication of existing self-shaping materials are limited by the inseparable monotonic relationship between their deformation rate and deformation degree (i.e., a higher deformation rate is accompanied by a high deformation degree). This causes that they can only deform from 2D to 3D states. Here, a simple yet versatile strategy to decouple the monotonic correlation between the deformation rate and deformation degree of self-shaping hydrogels is presented for achieving complex deformations from 2D to temporary 3D to 3D (2D-to-4D). It is demonstrated that when the gradient hydrogels prepared by photopolymerization possess dense polymer networks, the local regions with a high deformation rate can exhibit a low deformation degree. The resulting hydrogels can thus deform in a novel 2D-to-4D mode under external stimuli. During the deformation, they first transform into the temporary shapes induced by the local deformation rate difference, and then transform into the final shapes determined by the local deformation degree difference. Through controlling the ultraviolet irradiation direction and time to precisely program the local gradients of self-shaping hydrogels, they can be designed to produce various unprecedented yet controllable 2D-to-4D shape evolutions on demand, such as transformable origami, sequential gesture actions in finger-guessing games, mobile octopuses, time switch, etc.


Asunto(s)
Hidrogeles , Polímeros
20.
Int J Clin Pract ; 75(10): e14585, 2021 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-34192400

RESUMEN

INTRODUCTION: Many concerns were raised about the outcome of non-vitamin K antagonist oral anticoagulants compared with warfarin in subjects with atrial fibrillation and liver disease. However, the reported relationship between their efficacy and safety was variable. This meta-analysis was performed to evaluate this relationship. METHODS: A systematic literature search up to July 2020 was performed and six studies included 50 074 subjects with atrial fibrillation and liver disease at the baseline with 32 229 non-vitamin K antagonist oral anticoagulant consumers and 18 920 warfarin consumers. They were reporting relationships between non-vitamin K antagonist oral anticoagulants and warfarin in subjects with atrial fibrillation and liver disease. Odds ratio (OR) with 95% confidence intervals (CIs) was calculated to evaluate the prognostic role of the efficacy and safety of non-vitamin K antagonist oral anticoagulants compared with warfarin in subjects with atrial fibrillation and liver disease subjects using the dichotomous method with a random or fixed-effect model. RESULTS: Non-vitamin K antagonist oral anticoagulants consumption was significantly related to lower all-cause mortality in subjects with atrial fibrillation and liver disease (OR, 0.90; 95% CI, 0.81-0.99, P = .03); lower intracranial haemorrhage (OR, 0.67; 95% CI, 0.55- 0.82, P < .001) and low stroke and system embolism (OR, 0.76; 95% CI, 0.68-0.86, P < .001) compared with warfarin consumption. However, non-vitamin K antagonist oral anticoagulants consumption was not significantly related to lower major bleeding in subjects with atrial fibrillation and liver disease (OR, 0.73; 95% CI, 0.52-1.02, P = .06); and gastrointestinal bleeding (OR, 0.93; 95% CI, 0.58-1.49, P = .77) compared with warfarin consumption. CONCLUSIONS: Based on this meta-analysis, non-vitamin K antagonist oral anticoagulant consumption may have an independent lower risk relationship with all-cause mortality, intracranial haemorrhage, and stroke and system embolism compared with warfarin consumption in subjects with atrial fibrillation and liver disease. This relationship forces us to recommend non-vitamin K antagonist oral anticoagulant use in subjects with atrial fibrillation and liver disease for better outcomes and to avoid any possible complications. Further studies are required.


Asunto(s)
Fibrilación Atrial , Hepatopatías , Accidente Cerebrovascular , Administración Oral , Anticoagulantes/efectos adversos , Fibrilación Atrial/complicaciones , Fibrilación Atrial/tratamiento farmacológico , Hemorragia Gastrointestinal , Humanos , Hepatopatías/complicaciones , Accidente Cerebrovascular/tratamiento farmacológico , Accidente Cerebrovascular/prevención & control , Warfarina/efectos adversos
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