Evidence mapPaperPMID 36698921Full record

SynthesisFrontiers in cardiovascular medicine2022

Efficacy and safety outcomes of long-term anti-thrombotic treatment of chronic coronary artery disease: A systematic review and network meta-analysis.

Nayrouz Adawi, Victoria Rotshild, Stav Yanko, Mohammad Mowaswes, Offer Amir, Gal Haitner, Ilan Matok, Bruria Hirsh Raccah

Open access · goldAbstract readSystematic Review
In one paragraph

Synthesis in Frontiers in cardiovascular medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact, top 100% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed, 0 citations in OpenAlex.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 1 country.

Nayrouz AdawiDivision of Clinical Pharmacy, Faculty of Medicine, School of Pharmacy, Institute for Drug Research, Hebrew University of Jerusalem, Jerusalem, Israel.
Victoria RotshildDivision of Clinical Pharmacy, Faculty of Medicine, School of Pharmacy, Institute for Drug Research, Hebrew University of Jerusalem, Jerusalem, Israel.
Stav YankoDivision of Clinical Pharmacy, Faculty of Medicine, School of Pharmacy, Institute for Drug Research, Hebrew University of Jerusalem, Jerusalem, Israel.
Mohammad MowaswesDepartment of Cardiology, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
Offer AmirDepartment of Cardiology, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel.
Gal HaitnerDivision of Clinical Pharmacy, Faculty of Medicine, School of Pharmacy, Institute for Drug Research, Hebrew University of Jerusalem, Jerusalem, Israel.
Ilan MatokDivision of Clinical Pharmacy, Faculty of Medicine, School of Pharmacy, Institute for Drug Research, Hebrew University of Jerusalem, Jerusalem, Israel.
Bruria Hirsh RaccahDivision of Clinical Pharmacy, Faculty of Medicine, School of Pharmacy, Institute for Drug Research, Hebrew University of Jerusalem, Jerusalem, Israel.
Hebrew University of Jerusalem · ILHadassah Medical Center · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Clopidogrel, prasugrel, ticagrelor, and low-dose rivaroxaban are all optional strategies in conjunction with aspirin for long-term treatment of chronic coronary artery disease. The aim of this research was to assess the efficacy and safety of long-term anti-thrombotic treatment of chronic coronary heart disease. Methods: PubMed (MEDLINE), Embase, Clinical Trials Registry ClinicalTrials.gov, and The Cochrane Library were searched through November 2021, to identify randomized controlled trials that compared long term anti-thrombotic therapy for coronary heart disease. Data were extracted to assess eligibility by two independent reviewers. Random-effects meta-analysis was used to pool results. Results: Eleven randomized controlled trials were included (88,462 patients). In a network meta-analysis, the rivaroxaban compared to the clopidogrel regimen showed lower relative risks (RRs) for death of any cause (0.71; 95% confidence interval [CI], 0.52-0.96), major adverse cardiac events (MACE) (0.73; 95% CI, 0.57-0.93), and cerebrovascular events (0.48; 95% CI, 0.30-0.78). The RR of cerebrovascular events was also lower for the rivaroxaban compared to the ticagrelor 60 mg regimen (0.72; 95% CI, 0.52-0.99). For the prasugrel regimen, the RRs were lower of myocardial infarction incidence versus all extended strategies: clopidogrel plus aspirin (0.76; 95% CI, 0.58-0.99), rivaroxaban (0.60; 95% CI, 0.38-0.93), ticagrelor 60 mg (0.61; 95% CI, 0.42-0.89), and ticagrelor 90 mg (0.63; 95% CI, 0.41-0.97). None of the dual strategies were associated with differences in major bleeding compared to the prasugrel regimen. Conclusions and relevance: The rivaroxaban regimen appeared to be the preferred long-term anti-thrombotic regimen in preventing all-cause mortality. Our available results tend to support the efficacy of extended anti-thrombotic therapy consisting of prasugrel in lowering MI incidence compared to the other strategies, without increased risk of bleeding. However, additional large-scale direct clinical trials are needed to further determine the adequate long-term anti-thrombotic regimens for treating chronic coronary syndrome. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020186583, identifier CRD42020186583.

Indexed as

anticoagulationchronic coronary syndrome (CCS)dual-anti plateletlong anti-thrombotic strategiesnetwork meta-analysis (NMA)

Identifiers

PMID36698921
PMCPMC9868614
OpenAlexW4313894469

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.