Xueying Ding1, Xi Liu1, Changhong Tan1, Maojia Yin1, Teng Wang1, Ying Liu1, Lijuan Mo1, Xin Wei1, Xinjie Tan1, Fen Deng2, Lifen Chen3. 1. Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China. 2. Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China. Electronic address: dengf1996@126.com. 3. Department of Neurology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China. Electronic address: 300273@hospital.cqmu.edu.cn.
Abstract
BACKGROUND: Clinical disagreement over antiplatelet (AP) resumption in patients with primary intracranial hemorrhage (ICH) has long existed. This meta-analysis aimed to evaluate the benefits of AP resumption on preventing ischemic or thromboembolic events against its risks of promoting ICH recurrence or hematoma expansion. METHODS: All relevant articles published in Pubmed, EMBASE, the Cochrane Library, and Science Direct from January 1950 to March 2017 were sourced, and the combined relative risk (RR) was calculated. RESULTS: A total of 3648 articles were found, and after screening, 6 cohort studies including 1916 patients were included in this meta-analysis. AP resumption was associated with a decreased risk of ischemic or thromboembolic events (RR, 0.61; 95% confidence interval (CI), 0.48-0.79; P<0.01). There was no significant difference in the risk of ICH recurrence or hematoma expansion between patients with or without AP resumption (RR, 0.84; 95% CI, 0.47-1.51; P=0.56). CONCLUSION: AP resumption in patients with primary ICH reduced the risk of ischemic or thromboembolic events, without significant increase of risk of ICH recurrence or hematoma expansion.
BACKGROUND: Clinical disagreement over antiplatelet (AP) resumption in patients with primary intracranial hemorrhage (ICH) has long existed. This meta-analysis aimed to evaluate the benefits of AP resumption on preventing ischemic or thromboembolic events against its risks of promoting ICH recurrence or hematoma expansion. METHODS: All relevant articles published in Pubmed, EMBASE, the Cochrane Library, and Science Direct from January 1950 to March 2017 were sourced, and the combined relative risk (RR) was calculated. RESULTS: A total of 3648 articles were found, and after screening, 6 cohort studies including 1916 patients were included in this meta-analysis. AP resumption was associated with a decreased risk of ischemic or thromboembolic events (RR, 0.61; 95% confidence interval (CI), 0.48-0.79; P<0.01). There was no significant difference in the risk of ICH recurrence or hematoma expansion between patients with or without AP resumption (RR, 0.84; 95% CI, 0.47-1.51; P=0.56). CONCLUSION: AP resumption in patients with primary ICH reduced the risk of ischemic or thromboembolic events, without significant increase of risk of ICH recurrence or hematoma expansion.
Authors: Rustam Al-Shahi Salman; Gordon D Murray; Martin S Dennis; David E Newby; Peter A G Sandercock; Nikola Sprigg; Cathie L M Sudlow; David J Werring; Philip M White; William N Whiteley Journal: Trials Date: 2019-03-25 Impact factor: 2.279
Authors: Santosh B Murthy; Alessandro Biffi; Guido J Falcone; Lauren H Sansing; Victor Torres Lopez; Babak B Navi; David J Roh; Pitchaiah Mandava; Daniel F Hanley; Wendy C Ziai; Hooman Kamel; Jonathan Rosand; Kevin N Sheth Journal: Stroke Date: 2019-09-20 Impact factor: 10.170