Evidence map›Paper›PMID 30539518›Full record

SynthesisHepatology international2019

Use of anti-platelet agents in the prevention of hepatic fibrosis in patients at risk for chronic liver disease: a systematic review and meta-analysis.

Umair Iqbal, Brittany B Dennis, Andrew A Li, George Cholankeril, Donghee Kim, Muhammad Ali Khan, Aijaz Ahmed

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Hepatology international, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed, 2 pooled it
1.8field-weighted citation impact, top 15% 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

20 citing papers in PubMed, 2 syntheses or guidelines pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Review
  5. Preventing the progression of cirrhosis to decompensation and death.Nature reviews. Gastroenterology & hepatology · 2025
    Review
  6. Review
  7. Article
  8. Article
  9. Review
  10. Review
  11. Article
  12. Article
  13. Article
  14. Non-invasive biomarkers of Fontan-associated liver disease.JHEP reports : innovation in hepatology · 2021
    Article
  15. Article
  16. Review
  17. Till Death Do Us Part-The Multifaceted Role of Platelets in Liver Diseases.International journal of molecular sciences · 2021
    Review
  18. Article
  19. Review
  20. Article
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

7 authors at 4 institutions in 2 countries.

Umair IqbalDepartment of Medicine, Geisinger Commonwealth School of Medicine, 100 North Academy Avenue, Danville, PA, 17821, USA. uiqbal@geisinger.edu.ORCID http://orcid.org/0000-0001-5857-9391
Brittany B DennisSt. George's Hospital Medical School, University of London, London, UK.
Andrew A LiDepartment of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
George CholankerilDivision of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
Donghee KimDivision of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
Muhammad Ali KhanDivision of Gastroenterology and Hepatology, University of Alabama at Birmingham, Birmingham, AL, USA.
Aijaz AhmedDivision of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, USA.
Stanford University · USGeisinger Medical Center · USUniversity of Alabama at Birmingham · USUniversity of London · GB

Funding

TRAINING GRANT IN ACADEMIC GASTROENTEROLOGYT32DK007056 · NIDDK · STANFORD UNIVERSITY · PI Natalie J. Torok · 1986 to 2026
$6.5M
NIDDK NIH HHS T32 DK007056
6 · The paper itself

Abstract

BACKGROUND AND

aimsWhile the association between platelet activation and hepatic fibrosis has been previously demonstrated in animal studies; the utility of anti-platelet agents in reversing the progression of hepatic fibrosis requires further review. Utilizing systematic review methods, we provide to our knowledge the first meta-analysis combining evidence from all studies aimed to establish the effect of anti-platelet agents in the prevention of hepatic fibrosis.

methodsWe searched Medline, EMBASE and PubMed databases from inception to October 2018 to identify all studies aimed at evaluating the role of anti-platelet agents in the prevention of hepatic fibrosis. The primary outcome was hepatic fibrosis. The initial title, abstract, and full-text screening were performed in duplicate. Risk of bias was evaluated using the Newcastle-Ottawa Scale. A fixed-effect generic inverse variance method was used to create a pooled estimate of the odds of hepatic fibrosis in patients with anti-platelet agents versus without anti-platelet agents.

resultsAmong the 2310 unique articles identified during the title screening, 4 studies with a combined population of 3141 patients were deemed eligible for inclusion into the meta-analysis establishing the effect of anti-platelet agents on hepatic fibrosis. One study failed to report their findings in the entire cohort, electing to instead summarize the effects of anti-platelets within subgroups categorized by fibrotic risk factors. Use of anti-platelets was associated with 32% decreased odds of hepatic fibrosis, (adjusted pooled OR 0.68; CI 0.56-0.82, p ≤ 0.0001). The statistical heterogeneity among the studies was insignificant.

conclusionUse of anti-platelet agents is associated with the decreased odds of hepatic fibrosis. Due to limited evidence, future high-quality randomized controlled trials with larger comparative samples are required to further delineate the potential beneficial effects of these drugs in preventing hepatic fibrosis.

Indexed as

AdultAgedChronic DiseaseEnd Stage Liver DiseaseFemaleHumansLiver CirrhosisMaleMiddle AgedPlatelet Aggregation InhibitorsRisk FactorsTreatment OutcomePlatelet Aggregation InhibitorsAnti-plateletsAspirinHepatic fibrosisSystematic review

Identifiers

PMID30539518
PMCPMC6675411
OpenAlexW2904669002

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.