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Use of oral anticoagulant drugs is associated with carotid intraplaque hemorrhage in atherosclerosis patients: a meta-analysis

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Abstract

Patients with carotid atherosclerosis, especially the elderly population, take antithrombotic medicine regularly. However, no previous meta-analysis has focused on one of the possible side effects of such drugs, namely intraplaque hemorrhage (IPH). To determine whether antiplatelet drugs or anticoagulants are associated with an increased risk of carotid IPH. We searched Pubmed, Embase, Ovid MEDLINE, Cochrane Library for relevant studies that were published in English, from January 1st, 1989 to January 1st, 2019. We pooled the odds ratio (OR) with 95% confidence interval (CI) from individual studies and conducted quality assessment, heterogeneity, publication bias analysis and sensitivity analysis. A total of four cross-sectional studies, involving 2714 participants with carotid atherosclerotic plaques was included into this meta-analysis. We found a significant association between the use of anticoagulants and higher risk of carotid IPH (OR 1.95; 95% CI 1.16–3.30, P = 0.92; I2 = 0). No significant association was found between the use of antiplatelet drugs and increased risk of carotid IPH (OR 1.34; 95% CI 0.68–2.61, P = 0.03; I2 = 65%). Our meta-analysis reveals that it is the use of oral anticoagulants rather than antiplatelet drugs that may be associated with an increased risk of carotid IPH in atherosclerosis patients.

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Change history

  • 14 May 2019

    The article Use of oral anticoagulant drugs is associated with carotid intraplaque hemorrhage in atherosclerosis patients: a meta‑analysis, written by Xin Cao, Jun Zhang and Daoying Geng, was originally published electronically on the publisher's internet portal (currently SpringerLink) on April 2019 with open access. With the author(s)' decision to step back from Open Choice, the copyright of the article changed on May 2019 to © Springer Science+Business Media, LLC, part of Springer Nature 2019 and the article is forthwith distributed under the terms of copyright

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Acknowledgements

All authors have full access to all data in the study. Daoying Geng and Jun Zhang take responsibility for the integrity of the data and the accuracy of data analysis. All Authors read and approved the final version of the manuscript.

Funding

The research was funded by the National Key Research and Development Program of China (Grant No. 2016YFA0203700), the Shanghai Municipal Commission of Health (No. 2017BR003), and Shanghai Municipal Commission of Science and Technology (No. 16QA1400900, No. 16410722800, No. 17411953700).

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Author notes

  1. Jun Zhang and Daoying Geng contributed equally to this article.

Authors and Affiliations

  1. Department of Radiology, Huashan Hospital, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040, China

    Xin Cao, Jun Zhang & Daoying Geng

  2. Institute of Functional and Molecular Medical Imaging, Fudan University, No. 12 Wulumuqi Road (Middle), Shanghai, 200040, China

    Jun Zhang & Daoying Geng

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  1. Xin Cao
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Correspondence to Jun Zhang or Daoying Geng.

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The original version of this article was revised: The article was originally published in SpringerLink with open access. With the author(s)’ decision to step back from Open Choice, the copyright of the article changed on May 2019 to © Springer Science+Business Media, LLC, part of Springer Nature 2019.

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Cao, X., Zhang, J. & Geng, D. Use of oral anticoagulant drugs is associated with carotid intraplaque hemorrhage in atherosclerosis patients: a meta-analysis. J Thromb Thrombolysis 48, 68–76 (2019). https://doi.org/10.1007/s11239-019-01865-2

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