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2015 ; 94
(31
): e1293
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A Meta-Analysis of Randomized Controlled Trials on Antiplatelet Agents Versus
Placebo/Control for Treating Peripheral Artery Disease
#MMPMID26252306
Qian J
; Yang XH
Medicine (Baltimore)
2015[Aug]; 94
(31
): e1293
PMID26252306
show ga
Effect of aspirin (antiplatelet agents) in patients with peripheral artery
disease (PAD) was still controversial. Varying studies reported varying results.
Therefore, we did this meta-analysis to investigate if aspirin could reduce
cardiovascular events in patients with PAD.A comprehensive literature search
(PubMed, CCTR, Embase, Web of Science, CNKI, CBM-disc, and relevant websites) was
conducted from 1990 to September 2014. The key search terms ("aspirin," "PAD,"
"peripheral arterial occlusive diseases," and "claudication") produced 9
high-quality randomized controlled trials (RCTs) of aspirin versus
placebo/control. Mantel-Haenszel random-effects model was used to analysis of the
9 RCTs. The primary outcome was the cardiovascular events.Nine RCTs, composed of
9526 patients (4786 aspirin-treated and 4740 placebo or control-treated
patients), were meta-analyzed. The results indicated that compared to
placebo/control, aspirin could not significantly reduce the cardiovascular events
(OR?=?0.81, 95% CI?=?0.56-1.15). Moreover, aspirin could not produce better
effect on prevention of nonfatal myocardial infarction (OR?=?0.98, 95%
CI?=?0.52-1.84), nonfatal stroke (OR?=?0.89, 95% CI?=?0.69-1.14), cardiovascular
death (OR?=?0.97, 95% CI?=?0.68-1.38), any death (OR?=?1.05, 95% CI?=?0.85-1.30),
and major bleeding (OR?=?1.16, 95% CI?=?0.82-1.65) than placebo/control. But
aspirin, as monotherapy therapy, did significantly reduce the risk of nonfatal
stroke (OR?=?0.42, 95% CI?=?0.21-0.84).Aspirin, as monotherapy or combination
therapy, did not result in a significant decrease in the cardiovascular events.
But aspirin, as monotherapy therapy, did significantly reduce the risk of
nonfatal stroke. Our conclusion might help clinicians in clinical treating PAD.
Future studies are needed to draw firm conclusions about the clinical benefit and
risks of aspirin and other antiplatelet agents.