Evidence map›Paper›PMID 28095449›Full record

Trial reportPloS one2017

Does Antiplatelet Therapy during Bridging Thrombolysis Increase Rates of Intracerebral Hemorrhage in Stroke Patients?

Anne Broeg-Morvay, Pasquale Mordasini, Agnieszka Slezak, Kai Liesirova, Julia Meisterernst, Gerhard Schroth, Marcel Arnold, Simon Jung, Heinrich P Mattle, Jan Gralla and 1 more

Abstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

15 citing papers in PubMed, 1 synthesis or guideline pooled it.

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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

11 authors.

Anne Broeg-MorvayDepartment of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.ORCID http://orcid.org/0000-0002-8454-3680
Pasquale MordasiniDepartment of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
Agnieszka SlezakDepartment of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
Kai LiesirovaDepartment of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
Julia MeisterernstDepartment of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
Gerhard SchrothDepartment of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
Marcel ArnoldDepartment of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
Simon JungDepartment of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
Heinrich P MattleDepartment of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
Jan GrallaDepartment of Diagnostic and Interventional Neuroradiology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.
Urs FischerDepartment of Neurology, Inselspital, University Hospital Bern and University of Bern, Bern, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSymptomatic intracerebral hemorrhage (sICH) after bridging thrombolysis for acute ischemic stroke is a devastating complication. We aimed to assess whether the additional administration of aspirin during endovascular intervention increases bleeding rates.

methodsWe retrospectively compared bleeding complications and outcome in stroke patients who received bridging thrombolysis with (tPA+ASA) and without (tPA-ASA) aspirin during endovascular intervention between November 2008 and March 2014. Furthermore, we analyzed bleeding complications and outcome in antiplatelet naïve patients with those with prior or acute antiplatelet therapy.

resultsBaseline characteristics, previous medication, and dosage of rtPA did not differ between 50 tPA+ASA (39 aspirin naïve, 11 preloaded) and 181 tPA-ASA patients (p>0.05). tPA+ASA patients had more often internal carotid artery (ICA) occlusion (p<0.001), large artery disease (p<0.001) and received more often acute stenting of the ICA (p<0.001). 10/180 (5.6%) tPA-ASA patients and 3/49 (6.1%) tPA+ASA patients suffered a sICH (p = 1.0). Rates of asymptomatic intracerebral hemorrhage, systemic bleeding complications and outcome did not differ between both groups (p>0.1). There were no differences in bleeding complications and mortality among 112 bridging patients with antiplatelet therapy (62 preloaded, 39 acute administration, 11 both) and 117 antiplatelet naïve patients. In a logistic regression analysis, aspirin administration during endovascular procedure was not a predictor of sICH.

conclusionAntiplatelet therapy before or during bridging thrombolysis in patients with acute ischemic stroke did not increase the risk of bleeding complications and had no impact on outcome. This finding has to be confirmed in larger studies.

Indexed as

AgedCerebral HemorrhageFemaleHumansMalePlatelet Aggregation InhibitorsProspective StudiesRetrospective StudiesStrokeThrombolytic TherapyPlatelet Aggregation Inhibitors

Identifiers

PMID28095449
PMCPMC5240999

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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 OpenQuestion graph.