Evidence map›Paper›PMID 30563866›Full record

SynthesisBMJ (Clinical research ed.)2018

Clopidogrel plus aspirin versus aspirin alone for acute minor ischaemic stroke or high risk transient ischaemic attack: systematic review and meta-analysis.

Qiukui Hao, Malavika Tampi, Martin O'Donnell, Farid Foroutan, Reed Ac Siemieniuk, Gordon Guyatt

Open access · hybridAbstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 8 pooled it
15.4field-weighted citation impact, top 1% 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

57 citing papers in PubMed, 8 syntheses or guidelines pooled it, 152 citations in OpenAlex.

  1. Pooled it
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  9. P2YJournal of atherosclerosis and thrombosis · 2026
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  13. Observational
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  15. Endovascular treatment of intracranial aneurysms: Past and present.Journal of cerebrovascular and endovascular neurosurgery · 2024
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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

6 authors at 4 institutions in 4 countries.

Qiukui HaoThe Center of Gerontology and Geriatrics (National Clinical Research Center for Geriatrics), West China Hospital, Sichuan University, Chengdu, China haoqiukui@gmail.com.ORCID http://orcid.org/0000-0002-5160-5144
Malavika TampiAmerican Dental Association, Center for Evidence-based Dentistry, Chicago, IL, USA.
Martin O'DonnellHealth Research Board Clinical Research Facility, Department of Medicine, NUI Galway, Galway, Ireland.
Farid ForoutanDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.
Reed Ac SiemieniukDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.
Gordon GuyattDepartment of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Canada.
Impact · CAAmerican Dental Association · USOllscoil na Gaillimhe – University of Galway · IESichuan University · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo assess the effectiveness and safety of dual agent antiplatelet therapy combining clopidogrel and aspirin to prevent recurrent thrombotic and bleeding events compared with aspirin alone in patients with acute minor ischaemic stroke or transient ischaemic attack (TIA).

designSystematic review and meta-analysis of randomised, placebo controlled trials. DATA SOURCES: Medline, Embase, Cochrane Central Register of Controlled Trials, Cochrane Library, ClinicalTrials.gov, WHO website, PsycINFO, and grey literature up to 4 July 2018. ELIGIBILITY CRITERIA FOR SELECTING STUDIES AND

methodsTwo reviewers independently screened potentially eligible studies according to predefined selection criteria and assessed the risk of bias using a modified version of the Cochrane risk of bias tool. A third team member reviewed all final decisions, and the team resolved disagreements through discussion. When reports omitted data that were considered important, clarification and additional information was sought from the authors. The analysis was conducted in RevMan 5.3 and MAGICapp based on GRADE methodology.

resultsThree eligible trials involving 10 447 participants were identified. Compared with aspirin alone, dual antiplatelet therapy with clopidogrel and aspirin that was started within 24 hours of symptom onset reduced the risk of non-fatal recurrent stroke (relative risk 0.70, 95% confidence interval 0.61 to 0.80, I

conclusionsDual antiplatelet therapy with clopidogrel and aspirin given within 24 hours after high risk TIA or minor ischaemic stroke reduces subsequent stroke by about 20 in 1000 population, with a possible increase in moderate to severe bleeding of 2 per 1000 population. Discontinuation of dual antiplatelet therapy within 21 days, and possibly as early as 10 days, of initiation is likely to maximise benefit and minimise harms.

Indexed as

AspirinBrain IschemiaClopidogrelDrug Therapy, CombinationHemorrhageHumansIschemic Attack, TransientMortalityPlatelet Aggregation InhibitorsRecurrenceSecondary PreventionSeverity of Illness IndexStrokeAspirinClopidogrelPlatelet Aggregation Inhibitors

Identifiers

PMID30563866
PMCPMC6298178
OpenAlexW2904821510

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.