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Antiplatelet agents and anticoagulants for hypertension
CONCLUSIONS: There is no evidence that antiplatelet therapy modifies mortality in patients with elevated BP for primary prevention. ASA reduced the risk of cardiovascular events and increased the risk of major bleeding events. Antiplatelet therapy with ASA probably reduces the risk of non-fatal and all cardiovascular events when compared to clopidogrel. Clopidogrel increases the risk of major bleeding events compared to ASA in patients with elevated BP for secondary prevention. There is no evidence that warfarin modifies mortality in patients with elevated BP for secondary prevention. The benefits and harms of the newer dr...
Source: Cochrane Database of Systematic Reviews - July 28, 2022 Category: General Medicine Authors: Eduard Shantsila Monika Kozie ł-Siołkowska Gregory Yh Lip Source Type: research

Antithrombotic therapy to prevent cognitive decline in people with small vessel disease on neuroimaging but without dementia
CONCLUSIONS: We found no convincing evidence to suggest any clinically relevant cognitive benefit of using antithrombotic therapy in addition to standard treatment in people with cerebral small vessel disease but without dementia, but there may be an increased bleeding risk with this approach. There was marked heterogeneity across the trials and the certainty of the evidence was generally poor.PMID:35833913 | DOI:10.1002/14651858.CD012269.pub2
Source: Cochrane Database of Systematic Reviews - July 14, 2022 Category: General Medicine Authors: Joseph Kwan Melanie Hafdi Lorraine L W Chiang Phyo K Myint Li Siang Wong Terry J Quinn Source Type: research

Antiplatelet agents for chronic kidney disease
CONCLUSIONS: Antiplatelet agents probably reduced myocardial infarction and increased major bleeding, but do not appear to reduce all-cause and cardiovascular death among people with CKD and those treated with dialysis. The treatment effects of antiplatelet agents compared with each other are uncertain.PMID:35224730 | DOI:10.1002/14651858.CD008834.pub4
Source: Cochrane Database of Systematic Reviews - February 28, 2022 Category: General Medicine Authors: Patrizia Natale Suetonia C Palmer Valeria M Saglimbene Marinella Ruospo Mona Razavian Jonathan C Craig Meg J Jardine Angela C Webster Giovanni Fm Strippoli Source Type: research

Continuation versus discontinuation of antiplatelet therapy for bleeding and ischaemic events in adults undergoing non-cardiac surgery.
CONCLUSIONS: We found low-certainty evidence that either continuation or discontinuation of antiplatelet therapy before non-cardiac surgery may make little or no difference to mortality, bleeding requiring surgical intervention, or ischaemic events. We found moderate-certainty evidence that either continuation or discontinuation of antiplatelet therapy before non-cardiac surgery probably makes little or no difference to bleeding requiring transfusion. Evidence was limited to few studies with few participants, and with few events. The three ongoing studies may alter the conclusions of the review once published and assessed....
Source: Cochrane Database of Systematic Reviews - July 18, 2018 Category: General Medicine Authors: Lewis SR, Pritchard MW, Schofield-Robinson OJ, Alderson P, Smith AF Tags: Cochrane Database Syst Rev Source Type: research

Clopidogrel plus aspirin versus aspirin alone for preventing cardiovascular events.
CONCLUSIONS: The available evidence demonstrates that the use of clopidogrel plus aspirin in people at high risk of cardiovascular disease and people with established cardiovascular disease without a coronary stent is associated with a reduction in the risk of myocardial infarction and ischaemic stroke, and an increased risk of major and minor bleeding compared with aspirin alone. According to GRADE criteria, the quality of evidence was moderate for all outcomes except all-cause mortality (low quality evidence) and adverse events (very low quality evidence). PMID: 29240976 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 14, 2017 Category: General Medicine Authors: Squizzato A, Bellesini M, Takeda A, Middeldorp S, Donadini MP Tags: Cochrane Database Syst Rev Source Type: research

Antiplatelet versus anticoagulation treatment for patients with heart failure in sinus rhythm.
CONCLUSIONS: There is evidence from RCTs to suggest that neither oral anticoagulation with warfarin or platelet inhibition with aspirin is better for mortality in systolic heart failure with sinus rhythm (high quality of the evidence for all-cause mortality and moderate quality of the evidence for non-fatal cardiovascular events and major bleeding events). Treatment with warfarin was associated with a 20% reduction in non-fatal cardiovascular events but a twofold higher risk of major bleeding complications (high quality of the evidence). We saw a similar pattern of results for the warfarin versus clopidogrel comparison (lo...
Source: Cochrane Database of Systematic Reviews - September 14, 2016 Category: Journals (General) Authors: Shantsila E, Lip GY Tags: Cochrane Database Syst Rev Source Type: research

WITHDRAWN: Antiplatelet agents versus control or anticoagulation for heart failure in sinus rhythm.
CONCLUSIONS: At present there is little evidence from long term RCTs to recommend the use of antiplatelet therapy to prevent thromboembolism in patients with heart failure in sinus rhythm. A possible interaction with ACE inhibitors may reduce the efficacy of aspirin, although this evidence is mainly from retrospective analyses of trial cohorts and two RCTs. There is also no current evidence to support the use of oral anticoagulation (when compared to aspirin/clopidogrel) in patients with heart failure in sinus rhythm. Anticoagulation/antiplatelet therapy should be reserved for heart failure patients with other comorbiditie...
Source: Cochrane Database of Systematic Reviews - May 2, 2016 Category: Journals (General) Authors: Lip GY, Wrigley BJ, Pisters R Tags: Cochrane Database Syst Rev Source Type: research

Glycoprotein IIb-IIIa inhibitors for acute ischaemic stroke.
CONCLUSIONS: The available trial evidence showed that, for individuals with acute ischaemic stroke, GP IIb-IIIa inhibitors are associated with a significant risk of intracranial haemorrhage with no evidence of any reduction in death or disability in survivors. These data do not support their routine use in clinical practice. The conclusion is driven by trials of Abciximab, which contributed 89% of the total number of study participants considered. PMID: 24609741 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - March 8, 2014 Category: Journals (General) Authors: Ciccone A, Motto C, Abraha I, Cozzolino F, Santilli I Tags: Cochrane Database Syst Rev Source Type: research