Aspirin Versus Clopidogrel Monotherapy for the Secondary Prevention of Recurrent Cerebrovascular Attack Following Previous Ischemic Stroke in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis
Autor: | Pravesh Kumar Bundhun, Chao-Ying Lian, Xiu-Fang Yang, Min-Shi Lin, You-Yi Lao, Xun-Jin Yan, Zu-Ye Qin |
---|---|
Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
Antiplatelet drug Endocrinology Diabetes and Metabolism medicine.medical_treatment Cerebrovascular attack 030209 endocrinology & metabolism 030204 cardiovascular system & hematology 03 medical and health sciences 0302 clinical medicine Internal medicine Diabetes mellitus Type 2 diabetes mellitus Internal Medicine medicine cardiovascular diseases Myocardial infarction Stroke Original Research Aspirin business.industry medicine.disease Clopidogrel Meta-analysis Relative risk business medicine.drug |
Zdroj: | Diabetes Therapy |
ISSN: | 1869-6961 1869-6953 |
Popis: | Introduction Type 2 diabetes mellitus (T2DM) and stroke are two different diseases, but have many aspects in common. Aspirin is recommended as an initial treatment for the secondary prevention of recurrent ischemic stroke in patients with T2DM. However, clopidogrel is an oral antiplatelet drug that might be another choice in case of aspirin intolerance. In this analysis, we aimed to systematically compare aspirin versus clopidogrel monotherapy for the secondary prevention of recurrent cerebrovascular attack following previous ischemic stroke in patients with T2DM. Methods Online medical databases including Web of Science, MEDLINE, Cochrane central, EMBASE and http://www.ClinicalTrials.com were searched for published articles that satisfied the inclusion and exclusion criteria of this study. Recurrent stroke, fatal stroke, cerebral hemorrhage, myocardial infarction and mortality were considered the main end points in these patients with T2DM. RevMan 5.3 software was used to statistically analyze the data representing each subgroup. Risk ratios (RRs) with 95% confidence intervals (CIs) were used to represent the results following analysis. Results A total of 9218 participants with T2DM who were previously affected by ischemic stroke were included in this analysis, whereby 4917 were assigned to aspirin and 4301 to clopidogrel. This current analysis showed that there was no significant difference in recurrent stroke rate (RR: 0.79, 95% CI: 0.61–1.02; P = 0.07) observed with aspirin versus clopidogrel in these patients with T2DM. The risk of fatal stroke (RR: 0.88, 95% CI: 0.39–1.98; P = 0.76), cerebral hemorrhage (RR: 0.65, 95% CI: 0.38–1.11; P = 0.12), myocardial infarction (RR: 0.88, 95% CI: 0.43–1.79; P = 0.71) and mortality (RR: 1.07, 95% CI: 0.90–1.27; P = 0.44) were also similarly manifested. Conclusion Clopidogrel monotherapy was neither inferior nor superior to aspirin monotherapy for the secondary prevention of recurrent cerebrovascular attack following previous ischemic stroke in patients with T2DM. Hence, clopidogrel or aspirin monotherapy is equally safe and effective in these patients with T2DM. |
Databáze: | OpenAIRE |
Externí odkaz: | |
Nepřihlášeným uživatelům se plný text nezobrazuje | K zobrazení výsledku je třeba se přihlásit. |