Literature DB >> 14656836

Indirect comparison meta-analysis of aspirin therapy after coronary surgery.

Eric Lim1, Ziad Ali, Ayyaz Ali, Tom Routledge, Lyn Edmonds, Douglas G Altman, Stephen Large.   

Abstract

OBJECTIVES: To evaluate the efficacy of low and medium dose aspirin therapy after coronary surgery by using an indirect comparison meta-analysis. DATA SOURCES: Systematic literature search of Medline, Embase, Cochrane controlled trials register, and trial register sites on the internet. STUDY SELECTION: Outcome was evaluated by angiography and reported as graft occlusion and rate of events in patients. Trials that did not include aspirin as the sole therapy or did not have a placebo control arm were excluded. Articles were assessed for eligibility and quality and grouped according to dosage. The estimated difference in effect of low and medium dose aspirin on graft occlusion was obtained by combining the estimated log relative risks of low dose with placebo and medium dose with placebo.
RESULTS: For graft occlusion, the medium dose trials yielded a relative risk reduction of 45% compared with 26% for the low dose trials. The greater effect in the medium dose trials is summarised by a relative risk ratio of 0.74 (95% confidence interval 0.52 to 1.06; P = 0.10) for graft occlusion and 0.81 (0.57 to 1.16; P = 0.25) for events in patients.
CONCLUSIONS: Medium dose aspirin may more successfully reduce graft occlusion than low dose regimens within the first year after coronary surgery.

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Year:  2003        PMID: 14656836      PMCID: PMC286307          DOI: 10.1136/bmj.327.7427.1309

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  51 in total

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Authors:  Fujian Song; Douglas G Altman; Anne-Marie Glenny; Jonathan J Deeks
Journal:  BMJ       Date:  2003-03-01

Review 2.  Interaction revisited: the difference between two estimates.

Authors:  Douglas G Altman; J Martin Bland
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3.  Failure of antiplatelet and anticoagulant therapy to improve patency of grafts after coronary-artery bypass: a controlled, randomized study.

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4.  Effect of dipyridamole and aspirin on late vein-graft patency after coronary bypass operations.

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Journal:  N Engl J Med       Date:  1984-01-26       Impact factor: 91.245

5.  The effect of antiplatelet therapy on saphenous vein coronary artery bypass graft patency.

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Journal:  Circulation       Date:  1983-09       Impact factor: 29.690

6.  A platelet-inhibitor-drug trial in coronary-artery bypass operations: benefit of perioperative dipyridamole and aspirin therapy on early postoperative vein-graft patency.

Authors:  J H Chesebro; I P Clements; V Fuster; L R Elveback; H C Smith; W T Bardsley; R L Frye; D R Holmes; R E Vlietstra; J R Pluth; R B Wallace; F J Puga; T A Orszulak; J M Piehler; H V Schaff; G K Danielson
Journal:  N Engl J Med       Date:  1982-07-08       Impact factor: 91.245

7.  Differential inhibition by aspirin of vascular and platelet prostaglandin synthesis in atherosclerotic patients.

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Journal:  N Engl J Med       Date:  1983-04-07       Impact factor: 91.245

8.  Influence of aspirin and dipyridamole on patency of coronary artery bypass grafts.

Authors:  J E Mayer; W G Lindsay; W Castaneda; D M Nicoloff
Journal:  Ann Thorac Surg       Date:  1981-03       Impact factor: 4.330

9.  Aspirin and mortality from coronary bypass surgery.

Authors:  Dennis T Mangano
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Authors:  M T McEnany; E W Salzman; E D Mundth; R W DeSanctis; J W Harthorne; R M Weintraub; S Gates; W G Austen
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7.  Treatment of Adults With Treatment-Resistant Depression: Electroconvulsive Therapy Plus Antidepressant or Electroconvulsive Therapy Alone? Evidence From an Indirect Comparison Meta-Analysis.

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8.  Aspirin dosage for the prevention of graft occlusion in people undergoing coronary surgery: A systematic review and meta-analysis.

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Review 9.  Pleiotropic Effects of Acetylsalicylic Acid after Coronary Artery Bypass Grafting-Beyond Platelet Inhibition.

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10.  Expert position paper on the management of antiplatelet therapy in patients undergoing coronary artery bypass graft surgery.

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