Evidence map›Paper›PMID 33831086›Full record

ArticlePloS one2021

Clopidogrel response predicts thromboembolic events associated with coil embolization of unruptured intracranial aneurysms: A prospective cohort study.

Eiji Higashi, Shoji Matsumoto, Ichiro Nakahara, Taketo Hatano, Akira Ishii, Nobutake Sadamasa, Tsuyoshi Ohta, Takuma Ishihara, Keisuke Tokunaga, Mitsushige Ando and 17 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.3field-weighted citation impact, top 40% 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

3 citing papers in PubMed, 3 citations in OpenAlex.

  1. Article
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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

27 authors at 15 institutions in 2 countries.

Eiji HigashiDepartment of Neurosurgery, Stroke Center, Kokura Memorial Hospital, Kitakyushu, Japan.ORCID 0000-0002-3461-9149
Shoji MatsumotoDepartment of Neurology, Stroke Center, Kokura Memorial Hospital, Kitakyushu, Japan.
Ichiro NakaharaDepartment of Neurosurgery, Stroke Center, Kokura Memorial Hospital, Kitakyushu, Japan.
Taketo HatanoDepartment of Neurosurgery, Stroke Center, Kokura Memorial Hospital, Kitakyushu, Japan.
Akira IshiiDepartment of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Nobutake SadamasaDepartment of Neurosurgery, Stroke Center, Koseikai Takeda Hospital, Kyoto, Japan.
Tsuyoshi OhtaDepartment of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan.
Takuma IshiharaInnovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan.
Keisuke TokunagaDepartment of Cerebrovascular Medicine and Neurology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Mitsushige AndoDepartment of Neurosurgery, Shiga General Hospital, Moriyama, Japan.
Hideo ChiharaDepartment of Neurosurgery, Stroke Center, Kokura Memorial Hospital, Kitakyushu, Japan.
Konosuke FurutaDepartment of Neurology, Stroke Center, Kokura Memorial Hospital, Kitakyushu, Japan.
Tetsuya HashimotoDepartment of Neurology, University of California, Los Angeles, Los Angeles, CA, United States of America.
Koji TanakaDepartment of Neurology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Kazutaka SonodaDepartment of Neurology, Fukuoka Saiseikai General Hospital, Fukuoka, Japan.
Junpei KogeDepartment of Cerebrovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan.
Wataru TakitaDepartment of Neurology, National Hospital Organization Nagoya Medical Center, Nagoya, Japan.
Takuro HashikawaDepartment of Neurosurgery, St. Mary's Hospital, Kurume, Japan.
Yusuke FunakoshiDepartment of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Daisuke KondoDepartment of Neurology, Stroke Center, Kokura Memorial Hospital, Kitakyushu, Japan.
Takahiko KamataDepartment of Neurosurgery, Stroke Center, Kokura Memorial Hospital, Kitakyushu, Japan.
Atsushi TsujimotoDepartment of Neurology, Japan Community Health Care Organization Kyushu Hospital, Kitakyushu, Japan.
Takuya MatsushitaDepartment of Neurology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Hiroyuki MuraiDepartment of Neurology, International University of Health and Welfare, Narita, Japan.
Keitaro MatsuoDivision of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Aichi, Japan.
Takanari KitazonoDepartment of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Junichi KiraDepartment of Neurology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Kokura Memorial Hospital · JPKyushu University · JPNational Cerebral and Cardiovascular Center · JPAichi Cancer Center · JPGifu University Hospital · JPIjinkai Takeda General Hospital · JPInternational University of Health and Welfare · JPKyoto University · JPKyushu Hospital · JPNational Hospital Organization · JPNational Kyushu Medical Center · JPSaiseikai Fukuoka General Hospital · JPShiga Medical Center · JPSt Mary's Hospital · JPUniversity of California, Los Angeles · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePeriprocedural thromboembolic events are a serious complication associated with coil embolization of unruptured intracranial aneurysms. However, no established clinical rule for predicting thromboembolic events exists. This study aimed to clarify the significance of adding preoperative clopidogrel response value to clinical factors when predicting the occurrence of thromboembolic events during/after coil embolization and to develop a nomogram for thromboembolic event prediction.

methodsIn this prospective, single-center, cohort study, we included 345 patients undergoing elective coil embolization for unruptured intracranial aneurysm. Thromboembolic event was defined as the occurrence of intra-procedural thrombus formation and postprocedural symptomatic cerebral infarction within 7 days. We evaluated preoperative clopidogrel response and patients' clinical information. We developed a patient-clinical-information model for thromboembolic event using multivariate analysis and compared its efficiency with that of patient-clinical-information plus preoperative clopidogrel response model. The predictive performances of the two models were assessed using area under the receiver-operating characteristic curve (AUC-ROC) with bootstrap method and compared using net reclassification improvement (NRI) and integrated discrimination improvement (IDI).

resultsTwenty-eight patients experienced thromboembolic events. The clinical model included age, aneurysm location, aneurysm dome and neck size, and treatment technique. AUC-ROC for the clinical model improved from 0.707 to 0.779 after adding the clopidogrel response value. Significant intergroup differences were noted in NRI (0.617, 95% CI: 0.247-0.987, p < .001) and IDI (0.068, 95% CI: 0.021-0.116, p = .005).

conclusionsEvaluation of preoperative clopidogrel response in addition to clinical variables improves the prediction accuracy of thromboembolic event occurrence during/after coil embolization of unruptured intracranial aneurysm.

Indexed as

AgedBlood Vessel ProsthesisClopidogrelEmbolization, TherapeuticFemaleHumansIntracranial AneurysmMaleMiddle AgedPlatelet Aggregation InhibitorsProspective StudiesThromboembolismClopidogrelPlatelet Aggregation Inhibitors

Identifiers

PMID33831086
PMCPMC8031457
OpenAlexW3150535431

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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.