SynthesisJournal of neurology2020
Platelet function/reactivity testing and prediction of risk of recurrent vascular events and outcomes after TIA or ischaemic stroke: systematic review and meta-analysis.
Synthesis in Journal of neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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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.
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Who cites it
14 citing papers in PubMed, 31 citations in OpenAlex.
- Current status and future perspectives of platelet function-guided precision antiplatelet therapy for patients with cerebral infarction.Neuroprotection (Chichester, England) · 2026Review
- Pseudoaneurysms as a complication of stereoelectroencephalography: Case series and clinical recommendations.Epilepsia · 2026Article
- Clinical implications of platelet reactivity after antiplatelet initiation in patients with acute ischaemic stroke.BMC neurology · 2025Observational
- Exploring the relationship of platelet aggregation function with efficacy and safety outcomes following the administration of prasugrel and clopidogrel in patients with thrombotic stroke: a post hoc analysis of PRASTRO pooled studies.Journal of thrombosis and thrombolysis · 2025Article
- Cost-effectiveness of platelet function testing in dual antiplatelet therapy decision-making after intracranial aneurysm treatment with flow diversion.Neurosurgical review · 2024Article
- Molecular genomic and epigenomic characteristics related to aspirin and clopidogrel resistance.BMC medical genomics · 2024Article
- Potential Protein Signatures for Recurrence Prediction of Ischemic Stroke.Journal of the American Heart Association · 2024Article
- Impact of Platelet Hyperreactivity and Diabetes Mellitus on Ischemic Stroke Recurrence: A Single-Center Cohort Clinical Study.International journal of general medicine · 2024Article
- Personalized Dual Antiplatelet Therapy in Acute Coronary Syndromes: Striking a Balance Between Bleeding and Thrombosis.Current cardiology reports · 2023Review
- Antiplatelet Resistance: A Review of Concepts, Mechanisms, and Implications for Management in Acute Ischemic Stroke and Transient Ischemic Attack.Stroke (Hoboken, N.J.) · 2023Review
- Advances in Neurological Diseases and Stroke.Journal of cardiovascular development and disease · 2023Article
- Relationship between platelet aggregation and stroke risk after percutaneous coronary intervention: a PENDULUM analysis.Heart and vessels · 2022Article
- Comparison of Different Laboratory Tests to Identify "Aspirin Resistance" and Risk of Vascular Events among Ischaemic Stroke Patients: A Double-Blind Study.Journal of cardiovascular development and disease · 2022Article
- Antiplatelet Drugs for Neurointerventions: Part 2 Clinical Applications.Clinical neuroradiology · 2021Review
Corrections and comments
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Authors and funding
20 authors at 16 institutions in 9 countries.
Funding
Abstract
backgroundThe prevalence of ex vivo 'high on-treatment platelet reactivity (HTPR)' and its relationship with recurrent vascular events/outcomes in patients with ischaemic cerebrovascular disease (CVD) is unclear.
methodsA systematic review and meta-analysis was performed in accordance with the PRISMA statement. MEDLINE, EMBASE and Cochrane Library were searched for completed manuscripts until May 2019 on TIA/ischaemic stroke patients, ≥ 18 years, treated with commonly-prescribed antiplatelet therapy, who had platelet function/reactivity testing and prospective follow-up data on recurrent stroke/TIA, myocardial infarction, vascular death or other cerebrovascular outcomes. Data were pooled using random-effects meta-analysis. Primary outcome was the composite risk of recurrent stroke/TIA, myocardial infarction or vascular death. Secondary outcomes were recurrent stroke/TIA, severe stroke (NIHSS > 16) or disability/impairment (modified Rankin scale ≥ 3) during follow-up.
resultsAntiplatelet-HTPR prevalence was 3-65% with aspirin, 8-56% with clopidogrel and 1.8-35% with aspirin-clopidogrel therapy. Twenty studies (4989 patients) were included in our meta-analysis. There was a higher risk of the composite primary outcome (OR 2.93, 95% CI 1.90-4.51) and recurrent ischaemic stroke/TIA (OR 2.43, 95% CI 1.51-3.91) in patients with vs. those without 'antiplatelet-HTPR' on any antiplatelet regimen. These risks were also more than twofold higher in patients with vs. those without 'aspirin-HTPR' and 'dual antiplatelet-HTPR', respectively. Clopidogrel-HTPR status did not significantly predict outcomes, but the number of eligible studies was small. The risk of severe stroke was higher in those with vs. without antiplatelet-HTPR (OR 2.65, 95% CI 1.00-7.01). DISCUSSION: Antiplatelet-HTPR may predict risks of recurrent vascular events/outcomes in CVD patients. Given the heterogeneity between studies, further prospective, multi-centre studies are warranted.
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