Journal of Thrombosis and Thrombolysis

, Volume 48, Issue 1, pp 68–76 | Cite as

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

  • Xin Cao
  • Jun ZhangEmail author
  • Daoying GengEmail author


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.


Intraplaque hemorrhage Carotid atherosclerosis Antithrombotic Antiplatelet Anticoagulants 



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.


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).

Compliance with ethical standards

Conflict of interest

All authors declare no conflicts of interest.

Supplementary material

11239_2019_1865_MOESM1_ESM.txt (1 kb)
Supplementary material 1 (TXT 1 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019
corrected publication 2019

Authors and Affiliations

  1. 1.Department of Radiology, Huashan HospitalFudan UniversityShanghaiChina
  2. 2.Institute of Functional and Molecular Medical ImagingFudan UniversityShanghaiChina

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