SynthesisJournal of the American Heart Association2016
Intravenous Thrombolysis for Acute Ischemic Stroke in Patients Receiving Antiplatelet Therapy: A Systematic Review and Meta-analysis of 19 Studies.
Synthesis in Journal of the American Heart Association, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Impact of prior antiplatelet therapy on safety and efficacy of alteplase in acute ischemic stroke: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Pooled it
- Risk factors of haemorrhagic transformation for acute ischaemic stroke in Chinese patients receiving intravenous recombinant tissue plasminogen activator: a systematic review and meta-analysis.Stroke and vascular neurology · 2018Pooled it
- Antiplatelet pretreatment and outcomes in intravenous thrombolysis for stroke: a systematic review and meta-analysis.Journal of neurology · 2017Pooled it
- Optimizing Early Antithrombotic Therapy Within 24 Hours of Intravenous Thrombolysis in Acute Ischemic Stroke.CNS drugs · 2026Review
- Risk of intracranial haemorrhage in patients with acute ischaemic stroke and prior antiplatelet therapy.European stroke journal · 2026Article
- Cerebral microbleeds and risk of symptomatic hemorrhagic transformation following mechanical thrombectomy for large vessel ischemic stroke.Journal of neurology · 2024Article
- Feasibility and comparability of different platelet function tests in acute stroke with or without prior antiplatelet therapy.Frontiers in neurology · 2024Article
- Sex Differences in Outcomes of Intravenous Thrombolysis in Acute Ischemic Stroke Patients with Preadmission Use of Antiplatelets.CNS drugs · 2023Article
- Intravenous thrombolysis in patient with vertebrobasilar dolichoectasia and antiplatelet medication.Radiology case reports · 2022Article
- Hemorrhagic Transformation in Acute Ischemic Stroke: A Quantitative Systematic Review.Journal of clinical medicine · 2022Article
- European Stroke Organisation (ESO) guidelines on intravenous thrombolysis for acute ischaemic stroke.European stroke journal · 2021Article
- Thrombolysis in acute stroke under dual antiplatelet therapy: perspectives arising from translational studies.Neural regeneration research · 2021Article
- Predictors and Prognosis of Symptomatic Intracranial Hemorrhage in Acute Ischemic Stroke Patients Without Thrombolysis: Analysis of Data From the Chinese Acute Ischemic Stroke Treatment Outcome Registry.Frontiers in neurology · 2021Article
- Safety and efficacy of oral antiplatelet for patients who had acute ischaemic stroke undergoing endovascular therapy.Stroke and vascular neurology · 2020Article
- Antiplatelet therapy within 24 hours of tPA: lessons learned from patients requiring combined thrombectomy and stenting for acute ischemic stroke.Journal of cerebrovascular and endovascular neurosurgery · 2020Article
- Safety and efficacy of intravenous thrombolysis in stroke patients on prior antiplatelet therapy in the WAKE-UP trial.Neurological research and practice · 2020Article
- Measurement of Platelet Function in an Experimental Stroke Model With Aspirin and Clopidogrel Treatment.Frontiers in neurology · 2020Article
- Transfusion of Resting Platelets Reduces Brain Hemorrhage After Intracerebral Hemorrhage and tPA-Induced Hemorrhage After Cerebral Ischemia.Frontiers in neuroscience · 2019Article
- Simultaneous acute cardio-cerebral infarction: is there a consensus for management?Annals of translational medicine · 2018Review
- Novel Thrombolytic Drug Based on Thrombin Cleavable Microplasminogen Coupled to a Single-Chain Antibody Specific for Activated GPIIb/IIIa.Journal of the American Heart Association · 2017Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe safety and long-term outcome of systemic thrombolysis in patients receiving antiplatelet medications remain subjects of great clinical significance. The objective of this meta-analysis was to determine how prestroke antiplatelet therapy affects the risks and benefits of intravenous thrombolysis in patients with acute ischemic stroke. METHODS AND
resultsA dual-reviewer search was conducted in PubMed and EMBASE databases through November 2015, from which 19 studies involving a total of 108 588 patients with acute ischemic stroke were identified based on preset inclusion criteria. Information on study designs, patient characteristics, exposures, outcomes, and adjusting confounders was extracted, and estimates were combined by using random-effects models. The pooled crude estimates suggested that taking long-term antiplatelet medications was associated with higher odds of symptomatic intracranial hemorrhage (odds ratio [OR] 1.70, 95% CI 1.47-1.97) and death (OR 1.46, 95% CI 1.22-1.75) and lower odds of favorable functional outcomes (OR 0.86, 95% CI 0.80-0.93). However, the combined confounder-adjusted results only confirmed a relatively weak positive association between prior antiplatelet therapy and symptomatic intracranial hemorrhage (OR 1.21, 95% CI 1.02-1.44) and demonstrated no significant relationship between antiplatelet therapy and the other 2 outcomes (favorable outcome OR 1.09, 95% CI 0.96-1.24; death OR 1.02, 95% CI 0.98-1.07). Subgroup analyses revealed that the associations between prestroke antiplatelet therapy and outcomes were dependent on time and antiplatelet agents.
conclusionsPatients with acute ischemic stroke receiving long-term antiplatelet medications were associated with greater risks of developing symptomatic intracranial hemorrhage after systemic thrombolysis. However, the overall independent association between prestroke antiplatelet therapy and unfavorable outcomes or mortality was insignificant.
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Registered trials
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