Evidence map›Paper›PMID 37195594›Full record

ArticleInternal and emergency medicine2023

Optimal antiplatelet therapy for patients after antiplatelet therapy induced gastrointestinal bleeding: timing.

Bin Xiao, Zhishuai Ye, Rui Cheng, Zhen Han, Shanshan Wu, Guoxing Wang, Zeya Li, Tuo Liang, Shutian Zhang, Rongchong Huang

Abstract read
PubMed Publisher
In one paragraph

Article in Internal and emergency medicine, 2023. 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
0.4field-weighted citation impact, top 35% 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, 2 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 1 institution in 1 country.

Bin XiaoDepartment of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95, Yong'an Rd, Xicheng District, Beijing, 100050, China.
Zhishuai YeDepartment of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95, Yong'an Rd, Xicheng District, Beijing, 100050, China.
Rui ChengDepartment of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Beijing, 100050, China.
Zhen HanDepartment of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Shanshan WuDepartment of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Beijing, 100050, China.
Guoxing WangDepartment of Emergency, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Zeya LiDepartment of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95, Yong'an Rd, Xicheng District, Beijing, 100050, China.
Tuo LiangDepartment of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95, Yong'an Rd, Xicheng District, Beijing, 100050, China.
Shutian ZhangDepartment of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yongan Road, Beijing, 100050, China. zhangst@ccmu.edu.cn.
Rongchong HuangDepartment of Cardiology, Beijing Friendship Hospital, Capital Medical University, No.95, Yong'an Rd, Xicheng District, Beijing, 100050, China. rchuang@ccmu.edu.cn.ORCID 0000-0002-2607-2112
Capital Medical University · CN

Funding

Summit Talent Plan, Beijing Hospital Management Center DFL20190101
6 · The paper itself

Abstract

Adjusting antiplatelet strategies after antiplatelet-associated gastrointestinal bleeding (GIB) is a complex clinical challenge. To assess the risk of outcomes at different times of resumption of antiplatelet therapy in an attempt to find the optimal time to resume therapy. The study analyzed consecutive patients with antiplatelet-associated GIB from Beijing Friendship Hospital Information System between October 2019 and June 2022. The primary outcomes were recurrent bleeding, major adverse cardiovascular and cerebrovascular events (MACE), and all-cause death. Multivariate-adjusted Cox proportional hazards models were used to evaluate the risks of these outcomes. The receiver operating characteristic curve was used to find the optimal time to resume treatment. Of the 617 patients with GIB after antiplatelet therapy successfully followed up, the median follow-up was 246 (interquartile range: 120-466) days, most patients (87.36%) interrupted therapy after GIB and 45.22% resumed within 90 days, of which 35.13% resumed within 7 days and 64.87% resumed after 7 days. Resumption therapy had a low risk of recurrent bleeding (uninterrupted as a reference: HR 0.32, 95% CI 0.15-0.67, p = 0.003), MACE (no resumption as a reference: HR 0.66, 95% CI 0.45-0.98, p = 0.037), and all-cause death (no resumption as a reference: HR 0.18, 95% CI 0.08-0.40, p < 0.001). And resuming therapy within 7 days had a lower risk of MACE (HR 0.18, 95% CI 0.08-0.44, p < 0.001) than after 7 days without a significantly higher risk of re-bleeding. The optimal time point for resuming therapy in this study was 8.5 days. Resuming antiplatelet therapy after GIB provides better clinical benefits compared to discontinued and uninterrupted therapy, especially compared with resuming after 7 days, resuming within 7 days is associated with a lower risk of MACE and a less significant increased risk of recurrent bleeding, leading to a higher net clinical benefit. China Clinical Trial Registration: ChiCTR2200064063.

Indexed as

Gastrointestinal HemorrhagePlatelet Aggregation InhibitorsAnticoagulantsChinaHumansRiskAnticoagulantsPlatelet Aggregation InhibitorsAntiplateletGastrointestinal bleeding, GIBNet clinical benefitResumption strategy

Identifiers

PMID37195594
OpenAlexW4376871452

What OpenQuestion holds

Textmetadata
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.