Evidence map›Paper›PMID 35922714›Full record

SynthesisDrugs in R&D2022

Antiplatelets Versus Anticoagulation in Cervical Artery Dissection: A Systematic Review and Meta-analysis of 2064 Patients.

Abdulrahman Ibrahim Hagrass, Bashar Khaled Almaghary, Mohamed Abdelhady Mostafa, Mohamed Elfil, Sarah Makram Elsayed, Amira A Aboali, Aboalmagd Hamdallah, Mohammed Tarek Hasan, Mohammed Al-Kafarna, Khaled Mohamed Ragab and 1 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Drugs in R&D, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.1field-weighted citation impact, top 21% 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

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
  2. Article
  3. Article
  4. 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

11 authors at 6 institutions in 3 countries.

Abdulrahman Ibrahim HagrassFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Bashar Khaled AlmagharyFaculty of Pharmacy, Al-Azhar University-Gaza, Gaza Strip, Palestine.
Mohamed Abdelhady MostafaParadise Neurology and Rehabilitation Clinics, Alexandria, Egypt.
Mohamed ElfilDepartment of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, USA.
Sarah Makram ElsayedFaculty of Medicine, October 6 University, Giza, Egypt.
Amira A AboaliFaculty of Medicine, Alexandria University, El-Shatby, 22 El-Guish Road, Alexandria, 21526, Egypt.
Aboalmagd HamdallahFaculty of Medicine, Al-Azhar University, Damietta, Egypt.
Mohammed Tarek HasanFaculty of Medicine, Al-Azhar University, Cairo, Egypt.
Mohammed Al-KafarnaFaculty of Pharmacy, Al-Azhar University-Gaza, Gaza Strip, Palestine.
Khaled Mohamed RagabFaculty of Medicine, Minia University, Minia, Egypt.
Mohamed Fahmy DoheimFaculty of Medicine, Alexandria University, El-Shatby, 22 El-Guish Road, Alexandria, 21526, Egypt. fahmydoheim@alumni.harvard.edu.ORCID http://orcid.org/0000-0001-8279-5078
Al-Azhar University · EGAl-Azhar University – Gaza · PSAlexandria University · EGMinia University · EGOctober 6 University · EGUniversity of Nebraska Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesIn young people aged < 50 years, cervical artery dissection (CeAD) is among the most common causes of stroke. Currently, there is no consensus regarding the safest and most effective antithrombotic treatment for CeAD. We aimed to synthesize concrete evidence from studies that compared the efficacy and safety of antiplatelet (AP) versus anticoagulant (AC) therapies for CeAD.

methodsWe searched major electronic databases/search engines from inception till September 2021. Cohort studies and randomized controlled trials (RCTs) comparing anticoagulants with antiplatelets for CeAD were included. A meta-analysis was conducted using articles that were obtained and found to be relevant. Mean difference (MD) with 95% confidence interval (CI) was used for continuous data and odds ratio (OR) with 95% CI for dichotomous data.

resultsOur analysis included 15 studies involving 2064 patients, 909 (44%) of whom received antiplatelets and 1155 (56%) received anticoagulants. Our analysis showed a non-significant difference in terms of the 3-month mortality (OR 0.47, 95% CI 0.03-7.58), > 3-month mortality (OR 1.63, 95% CI 0.40-6.56), recurrent stroke (OR 0.97, 95% CI 0.46-2.02), recurrent transient ischaemic attack (TIA) (OR 0.93, 95% CI 0.44-1.98), symptomatic intracranial haemorrhage (sICH) (OR 0.38, 95% CI 0.12-1.19), and complete recanalization (OR 0.70, 95% CI 0.46-1.06). Regarding primary ischaemic stroke, the results favoured AC over AP among RCTs (OR 6.97, 95% CI 1.25-38.83).

conclusionOur study did not show a considerable difference between the two groups, as all outcomes showed non-significant differences between them, except for primary ischaemic stroke (RCTs) and complete recanalization (observational studies), which showed a significant favour of AC over AP. Even though primary ischaemic stroke is an important outcome, several crucial points that could affect these results should be paid attention to. These include the incomplete adjustment for the confounding effect of AP-AC doses, frequencies, administration compliance, and others. We recommend more well-designed studies to assess if unnecessary anticoagulation can be avoided in CeAD.

Indexed as

Ischemic StrokeStrokeAdolescentAnticoagulantsArteriesHumansObservational Studies as TopicPlatelet Aggregation InhibitorsAnticoagulantsPlatelet Aggregation Inhibitors

Identifiers

PMID35922714
PMCPMC9433613
OpenAlexW4289637526

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.