Evidence map›Paper›PMID 31441862›Full record

ArticleMedicine2019

Antiplatelet therapy and coronary artery bypass grafting: Protocol for a systematic review and network meta-analysis.

Saurabh Gupta, Emilie P Belley-Côté, Bram Rochwerg, Anthony Bozzo, Puru Panchal, Arjun Pandey, Lawrence Mbuagbaw, Shamir Mehta, J-D Schwalm, Richard P Whitlock

Open access · goldAbstract read
In one paragraph

Article in Medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.5field-weighted citation impact, top 31% 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

1 citing paper in PubMed, 3 citations in OpenAlex.

  1. 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

10 authors at 4 institutions in 1 country.

Saurabh GuptaDepartment of Surgery.
Emilie P Belley-CôtéDepartment of Medicine.
Bram RochwergDepartment of Health Research Methods, Evidence and Impact.
Anthony BozzoDepartment of Surgery.
Puru PanchalFaculty of Health Sciences, McMaster University.
Arjun PandeyFaculty of Health Sciences, McMaster University.
Lawrence MbuagbawPopulation Health Research Institute, Hamilton, Ontario, Canada.
Shamir MehtaDepartment of Medicine.
J-D SchwalmDepartment of Medicine.
Richard P WhitlockDepartment of Surgery.
Population Health Research Institute · CAImpact · CAMcMaster University · CADepartment of Health Research

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionSaphenous vein graft (SVG) is the most common conduit used for coronary artery bypass grafting (CABG) surgery. Unfortunately, SVG are associated with poor long-term patency rates; a significant predictor of re-operation rates and survival. As such, medical therapy to prevent SVG narrowing or occlusion is of paramount importance. Aspirin (ASA) monotherapy is the standard of care after CABG, to improve long-term major adverse cardiovascular events (MACE) and graft patency. Benefits of dual antiplatelet therapy (DAPT) have not been well established in all CABG patients. We present a protocol for a network meta-analysis (NMA) comparing the effects of various antiplatelet therapy regimens on SVG patency, mortality, and bleeding among adult patients following CABG.

methodsWe will search CENTRAL, MEDLINE, EMBASE, CINAHL ACPJC, and grey literature sources (AHA, ACC, ESC, and CCC conference proceedings, ISRCTN Register, and WHO ICTRP) for randomized controlled trials (RCTs) which fit our criteria. RCTs that evaluate different antiplatelet regimens at least 3-months after CABG and have any of SVG patency, mortality, MACE, and major bleeding as outcomes will be selected. We will perform title and abstract screening, full-text screening, and data extraction independently and in duplicate. Two independent reviewers will also assess risk of bias (ROB) for each study, as well as evaluate quality of evidence using the GRADE framework. We will use R to perform the NMA and use low-dose ASA as reference within our network. We will report results as odds ratios with confidence intervals for direct comparisons, and credible intervals for indirect or mixed comparisons. We will use the surface under the cumulative ranking curve (SUCRA) to estimate the ranking of interventions. DISCUSSION: Given the limited direct comparison of various antiplatelet regimens, a network approach is ideal to clarify the optimum antiplatelet therapy after CABG. We hope that our NMA will be the largest quantitative synthesis evaluating antiplatelet regimens among patients requiring CABG. It should inform clinicians and guideline developers in selecting the most effective and safest antiplatelet regimen.Systematic Review registration: International Prospective Register for Systematic Reviews (PROSPERO)-CRD42019127695.

Indexed as

Coronary Artery BypassCoronary Artery DiseaseHumansNetwork Meta-Analysis as TopicPlatelet Aggregation InhibitorsSaphenous VeinSystematic Reviews as TopicTreatment OutcomePlatelet Aggregation Inhibitors

Identifiers

PMID31441862
PMCPMC6716708
OpenAlexW2969233303

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.