Bleeding complications caused by treatment of Aspirin and Clopidogrel for IS/TIA: a Meta-analysis
TIAN Fangyuan1,2 WU Bin1 XU Ting1
1.Department of Clinical Pharmacy, West China Hospital, Sichuan University, Sichuan Province, Chengdu 610041, China;
2.West China School of Pharmacy, Sichuan University, Sichuan Province, Chengdu 610041, China
Abstract:Objective To systematically assess the bleeding complications caused by treatment of Aspirin and Clopidogrel for ischemic stroke or transient ischemic attack. Methods Taking "ischemic stroke", "transient ischemic attack", "Aspirin" and "Clopidogrel" as the search terms to search the database. Databases of PubMed, EMBase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data were searched from inception to February 2017. Two reviewers independently screened literatures, extracted data and assessed quality of included studies. Then Meta-analysis was conducted by RevMan 5.3 software. Results A total of 15 studies involving 11 200 patients were included. The results of Meta-analysis showed that: during the treatment of ischemic stroke, drug combination could increase the risk of gastrointestinal bleeding (OR = 2.18, 95%CI: 1.43-3.34, P = 0.0003); during the treatment of transient ischemic attack/light stroke, drug combination could increase the risk of mild bleeding (OR = 1.50, 95%CI: 1.10-2.04, P = 0.01). Conclusion Based on current evidence, long term application of combination of Aspirin and Clopidogrel in the treatment of transient ischemic attack will increase the risk of mild bleeding, long term application of the two drugs in the treatment of ischemic stroke will increase the risk of gastrointestinal bleeding. Due to the impact of quantity and quality of the included studies, the conclusion above still needs carrying out more high-quality studies to confirm.
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