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Efficacy and safety of restarting antiplatelet therapy for patients with spontaneous intracranial haemorrhage: A systematic review and meta‐analysis
Author(s) -
Cheng Bo,
Li Jinze,
Peng Lei,
Wang Yirong,
Sun Ling,
He Shijia,
Wei Jing,
Zhang Shushan
Publication year - 2021
Publication title -
journal of clinical pharmacy and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.622
H-Index - 73
eISSN - 1365-2710
pISSN - 0269-4727
DOI - 10.1111/jcpt.13377
Subject(s) - medicine , meta analysis , cochrane library , intracranial haemorrhage , randomized controlled trial , clinical endpoint , cohort study , systematic review , medline , surgery , complication , political science , law
What is known and objective The benefits and risks of restarting antiplatelet therapy (APT) for patients with spontaneous intracranial haemorrhage (ICH) remain controversial. This meta‐analysis was performed to explore the efficacy and safety of restarting APT for these patients. Methods We followed the recommended PRISMA guidelines for systematic reviews. Studies from PubMed, Embase, Web of Science, CNKI and the Cochrane Library were systematically retrieved from the inception of each database to 31 July 2020. We also manually retrieved studies of reference. Results and discussion In this study, seven cohort studies and one randomized controlled trial (RCT) with subjects were included. APT resumption after spontaneous ICH did not significantly increase the risk of major haemorrhagic events (HR 1.15; 95% CI: 0.70–1.89; p = .59). However, it did not significantly reduce the risk of a composite endpoint concerning occlusive/thromboembolic events (HR 0.98; 95% CI: 0.81–1.19; p = .83) and all‐cause mortality (HR 0.93; 95% CI: 0.80–1.08; p = .35). What is new and conclusion Restarting APT for patients with spontaneous ICH is generally safe. However, the benefits of reducing the risk of ischaemic vascular events and all‐cause mortality were not apparent. More RCTs are required.