Evidence map›Paper›PMID 34355778›Full record

SynthesisCardiology journal2023

Increased risk of adverse events in patients with low-on clopidogrel platelet reactivity after percutaneous coronary intervention: A systematic review and meta-analysis.

Alexandra Bálint, Lilla Hanák, Péter Hegyi, Zsolt Szakács, Szimonetta Eitmann, András Garami, Margit Solymár, Katalin Márta, Zoltán Rumbus, András Komócsi

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Cardiology journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 34% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Challenges and prospects ofFrontiers in pharmacology · 2026
    Review
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 1 institution in 1 country.

Alexandra BálintHeart Institute, Medical School, University of Pécs, Hungary. alexandra.valentine91@gmail.com.ORCID 0000-0002-7267-8633
Lilla HanákInstitute for Translational Medicine, Medical School, University of Pécs, Hungary.
Péter HegyiInstitute for Translational Medicine, Medical School, University of Pécs, Hungary.
Zsolt SzakácsInstitute for Translational Medicine, Medical School, University of Pécs, Hungary.
Szimonetta EitmannInstitute for Translational Medicine, Medical School, University of Pécs, Hungary.
András GaramiDepartment of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Hungary.
Margit SolymárInstitute for Translational Medicine, Medical School, University of Pécs, Hungary.
Katalin MártaInstitute for Translational Medicine, Medical School, University of Pécs, Hungary.
Zoltán RumbusDepartment of Thermophysiology, Institute for Translational Medicine, Medical School, University of Pecs, Hungary.
András KomócsiHeart Institute, Medical School, University of Pécs, Hungary.
University of Pecs · HU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClinical evidence has been controversial regarding the influence of low platelet reactivity (LPR), ischemic and bleeding outcomes among patients receiving coronary stent implantation. Hence, the present study performed a meta-analysis to systematically evaluate the significance of LPR on adverse cardiovascular events.

methodsMEDLINE, EMBASE and CENTRAL databases were searched up to November 2020 for relevant studies including patients with acute coronary syndrome undergoing percutaneous coronary intervention. LPR was the exposed arm while the non-LPR group represented the control. The primary outcome of interest was bleeding risk including major and minor bleeding events. Secondary outcomes included all-cause mortality, repeated revascularization, nonfatal myocardial infarction, and stent thrombosis. Study-level outcomes were evaluated in random-effect models.

resultsA total of 20 studies with 19,064 patients were included. Pooled analysis showed that LPR was associated with an increased bleeding risk (relative risk [RR] 2.80, 95% confidence interval [CI] 1.95-4.02, p < 0.01). Patients with LPR had a lower risk of non-fatal myocardial infarction (RR 0.59, 95% CI 0.38-0.91, p < 0.05) and of serious vascular events (RR 0.50, 95% CI 0.30-0.84, p < 0.01).

conclusionsLow platelet reactivity is associated with an increased bleeding risk of patients who underwent coronary stent implantation. The results suggest possible benefits of this marker in risk stratification, with potential improvement in risk prediction. There are potential advantages using combinations with other factors in prediction models, however, they require further study. PROSPERO registration number: CRD42019136393).

Indexed as

Acute Coronary SyndromeMyocardial InfarctionPercutaneous Coronary InterventionClopidogrelHemorrhageHumansPlatelet Aggregation InhibitorsTreatment OutcomeClopidogrelPlatelet Aggregation Inhibitorsacute coronary syndromebleeding riskclopidogrellow platelet reactivitypercutaneous coronary intervention

Identifiers

PMID34355778
PMCPMC10287083
OpenAlexW3189376968

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.