High on treatment platelet reactivity to aspirin and clopidogrel in ischemic stroke : A systematic review and meta-analysis
Copyright © 2017 Elsevier B.V. All rights reserved..
Emerging studies highlight high on-treatment of platelet reactivity (HTPR) as a major hindrance to the secondary prevention of cardiovascular ischemic events. The aim of this systematic review and meta-analysis is to assess the prevalence of HTPR in patients with ischemic stroke (IS) or transient ischemic attack (TIA) and reveal a possible relation with a higher risk of cerebrovascular event recurrence. Studies were selected if they reported absolute numbers or percentages of HTPR with ASA or clopidogrel in IS/TIA patients at any time point after the cerebrovascular event onset and assessed with any type of platelet function tests. We included 52 full-text studies with a total of 8364 patients. Overall, the pooled prevalence of HTPR was 24% (95%CI: 20-27%). In subgroup analyses, the prevalence of HTPR on ASA was 23% (95%CI: 20-28%), on clopidogrel 27% (95%CI: 22-32%) and on dual antiplatelet treatment (DAPT) 7% (95%CI: 5-10%). The overall analysis of all studies providing data on the risk of IS/TIA recurrence, indicates that the patients with HTPR had a significantly higher risk for IS/TIA recurrence (RR=1.81, 95%CI: 1.30-2.52; p<0.001). In conclusion the present study shows a significant lower prevalence of HTPR in DAPT and an increased rate of recurrent cerebrovascular ischemic events in patients presenting HTPR.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:376 |
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| Enthalten in: |
Journal of the neurological sciences - 376(2017) vom: 15. Mai, Seite 112-116 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Fiolaki, Aidonio [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 21.02.2018 Date Revised 18.03.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jns.2017.03.010 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM271180587 |
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| 100 | 1 | |a Fiolaki, Aidonio |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a High on treatment platelet reactivity to aspirin and clopidogrel in ischemic stroke |b A systematic review and meta-analysis |
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| 500 | |a Date Revised 18.03.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2017 Elsevier B.V. All rights reserved. | ||
| 520 | |a Emerging studies highlight high on-treatment of platelet reactivity (HTPR) as a major hindrance to the secondary prevention of cardiovascular ischemic events. The aim of this systematic review and meta-analysis is to assess the prevalence of HTPR in patients with ischemic stroke (IS) or transient ischemic attack (TIA) and reveal a possible relation with a higher risk of cerebrovascular event recurrence. Studies were selected if they reported absolute numbers or percentages of HTPR with ASA or clopidogrel in IS/TIA patients at any time point after the cerebrovascular event onset and assessed with any type of platelet function tests. We included 52 full-text studies with a total of 8364 patients. Overall, the pooled prevalence of HTPR was 24% (95%CI: 20-27%). In subgroup analyses, the prevalence of HTPR on ASA was 23% (95%CI: 20-28%), on clopidogrel 27% (95%CI: 22-32%) and on dual antiplatelet treatment (DAPT) 7% (95%CI: 5-10%). The overall analysis of all studies providing data on the risk of IS/TIA recurrence, indicates that the patients with HTPR had a significantly higher risk for IS/TIA recurrence (RR=1.81, 95%CI: 1.30-2.52; p<0.001). In conclusion the present study shows a significant lower prevalence of HTPR in DAPT and an increased rate of recurrent cerebrovascular ischemic events in patients presenting HTPR | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Antiplatelet resistance | |
| 650 | 4 | |a Aspirin | |
| 650 | 4 | |a Clopidogrel | |
| 650 | 4 | |a High on treatment platelet reactivity (HTPR) | |
| 650 | 4 | |a Ischemic stroke | |
| 650 | 7 | |a Platelet Aggregation Inhibitors |2 NLM | |
| 650 | 7 | |a Clopidogrel |2 NLM | |
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| 650 | 7 | |a Ticlopidine |2 NLM | |
| 650 | 7 | |a OM90ZUW7M1 |2 NLM | |
| 650 | 7 | |a Aspirin |2 NLM | |
| 650 | 7 | |a R16CO5Y76E |2 NLM | |
| 700 | 1 | |a Katsanos, Aristeidis H |e verfasserin |4 aut | |
| 700 | 1 | |a Kyritsis, Athanassios P |e verfasserin |4 aut | |
| 700 | 1 | |a Papadaki, Styliani |e verfasserin |4 aut | |
| 700 | 1 | |a Kosmidou, Maria |e verfasserin |4 aut | |
| 700 | 1 | |a Moschonas, Iraklis C |e verfasserin |4 aut | |
| 700 | 1 | |a Tselepis, Alexandros D |e verfasserin |4 aut | |
| 700 | 1 | |a Giannopoulos, Sotirios |e verfasserin |4 aut | |
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