Antiplatelet therapy as a modulator of stroke aetiology: a meta-analysis

British Journal of Clinical Pharmacology
Christopher A RajkumarAlbert Ferro

Abstract

Antiplatelet therapy reduces the incidence of ischaemic stroke. Platelet-mediated thrombosis contributes variably to the major subtypes of stroke as defined by the TOAST criteria: large artery atherosclerosis (LAA), cardioembolic (CE) and small vessel occlusion (SVO). The effect of antiplatelet therapy on the incidence of each subtype is unknown and is the subject of this meta-analysis. Electronic databases were searched for articles comparing the effect of antiplatelet therapy on the incidence of stroke according to aetiological subtype. Studies containing subjects prescribed anticoagulant therapy or solely investigating subjects with atrial fibrillation were excluded. Pooled odds ratios (ORs) were calculated using a fixed effects model. Nine studies were included (n = 5739). In patients who had an ischaemic stroke, pre-event antiplatelet therapy was associated with significantly decreased incidence of LAA (OR 0.88, 95% CI 0.79, 0.99; P = 0.026), increased incidence of CE (OR 1.23, 95% CI 1.08, 1.41; P = 0.002) and no effect on SVO (OR 0.99, 95% CI 0.88, 1.11; P = 0.806). Concordant non-significant trends were observed in primary prevention populations (n = 751): LAA (OR 0.81, 95% CI 0.57, 1.15; P = 0.240), CE (OR 1.29, 95% CI...Continue Reading

References

Jan 1, 1990·Stroke; a Journal of Cerebral Circulation·C GustafssonJ Svensson
Jul 20, 1989·The New England Journal of Medicine·UNKNOWN Steering Committee of the Physicians' Health Study Research Group
Jan 30, 1988·British Medical Journal·R PetoS Norton
Sep 1, 1986·Controlled Clinical Trials·R DerSimonian, N Laird
Aug 1, 1982·Neurology·C M Fisher
Sep 30, 1994·Science·E S Lander, N J Schork
Oct 6, 1997·BMJ : British Medical Journal·M EggerC Minder
Oct 28, 1997·Stroke; a Journal of Cerebral Circulation·M W RiepeA Raupach
Sep 2, 1999·Stroke; a Journal of Cerebral Circulation·H IsoJ E Manson
Mar 21, 2000·The American Journal of Medicine·L KalraD Sulch
Dec 12, 2001·Stroke; a Journal of Cerebral Circulation·J L WilterdinkM D Hansen
Jul 1, 1965·Archives of Neurology·C M FISHER, H B CURRY
Mar 9, 2005·The New England Journal of Medicine·Paul M RidkerJulie E Buring
Dec 31, 2005·Neurology·N SanossianB Ovbiagele
Jun 24, 2006·Stroke; a Journal of Cerebral Circulation·Victor J MarderJeffrey L Saver
May 12, 2007·Thrombosis Research·Zaverio M Ruggeri
Sep 15, 2007·Journal of the Neurological Sciences·Bruce OvbiageleJeffrey L Saver
Sep 27, 2007·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·R LibmanW Barr
Sep 17, 2008·Haemophilia : the Official Journal of the World Federation of Hemophilia·A J Reininger
Nov 11, 2008·JAMA : the Journal of the American Medical Association·Hisao OgawaUNKNOWN Japanese Primary Prevention of Atherosclerosis With Aspirin for Diabetes (JPAD) Trial Investigators
Apr 9, 2009·Journal of the Neurological Sciences·G TelmanD Yarnitsky
Mar 4, 2010·JAMA : the Journal of the American Medical Association·F Gerald R FowkesUNKNOWN Aspirin for Asymptomatic Atherosclerosis Trialists
May 1, 2010·Stroke; a Journal of Cerebral Circulation·Wook-Joo KimHee-Joon Bae
Apr 13, 2011·The American Journal of Cardiology·Alfred A BartolucciGeorge Howard
Apr 19, 2011·Blood Reviews·Katleen BroosHans Deckmyn
Aug 13, 2011·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Alexandros L GeorgiadisAdnan I Qureshi
Aug 20, 2011·Arteriosclerosis, Thrombosis, and Vascular Biology·Naser AmmashWaldemar E Wysokinski
Sep 9, 2011·The New England Journal of Medicine·Marc I ChimowitzUNKNOWN SAMMPRIS Trial Investigators
Aug 31, 2012·The New England Journal of Medicine·UNKNOWN SPS3 InvestigatorsLesly A Pearce

❮ Previous
Next ❯

Citations

Apr 15, 2016·Thrombosis and Haemostasis·Thure Filskov OvervadPeter Søgaard
May 6, 2019·British Journal of Clinical Pharmacology·Simon B DimmittRobin E Ferner
Mar 6, 2021·European Heart Journal Supplements : Journal of the European Society of Cardiology·William A E ParkerRobert F Storey

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Filbrillation

Atrial fibrillation refers to the abnormal heart rhythm characterized by rapid and irregular beating of the atria. Here is the latest research.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.

Cardiovascular Disease Pathophysiology

Cardiovascular disease involves several different processes that contribute to the pathological mechanism, including hyperglycemia, inflammation, atherosclerosis, hypertension and more. Vasculature stability plays a critical role in the development of the disease. Discover the latest research on cardiovascular disease pathophysiology here.

Atherosclerosis Disease Progression

Atherosclerosis is the buildup of plaque on artery walls, causing stenosis which can eventually lead to clinically apparent cardiovascular disease. Find the latest research on atherosclerosis disease progression here.

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.