Individual patient data meta-analysis of antiplatelet regimens after noncardioembolic stroke or TIA: Rationale and design

Cerebrovascular Antiplatelet Trialists Collaborative Group

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: The Cerebrovascular Antiplatelet Trialists' Collaborative Group was formed to obtain and analyze individual patient data from the major randomized trials of common antiplatelet regimens after cerebral ischemia. Although the risk of stroke can be reduced by antiplatelet drugs, there continues to be uncertainty about the balance of risk and benefits of different antiplatelet regimens for an individual patient. Aims: Our aim is to provide clinicians with a thorough evidence-based answer on these therapeutic alternatives. Methods: We have identified six large randomized trials and plan to meta-analyze the data on an individual patient level. In total, these trials have enrolled 46948 patients with cerebral ischemia. Uniquely, the Cerebrovascular Antiplatelet Trialists' Collaborative Group has secured access to the individual data of all of these trials, with the participation of key investigators and pharmaceutical companies. Our principal objective includes deriving a reliable estimate of the efficacy of different antiplatelet regimens on key outcomes including serious vascular events, major ischemic events, major bleeding, and intracranial hemorrhage. Results: We propose to redefine composite outcome events, if necessary, to achieve comparability. Further, we aim to build and validate prognostic models for the risk of major bleeding and intracranial hemorrhage and to build a decision model that may support evidence-based decision making about which antiplatelet regimen would be most effective in different risk groups of patients. Conclusions: This paper outlines inclusion criteria, outcome measures, baseline characteristics, and planned statistical analysis.

Original languageEnglish
Pages (from-to)145-150
Number of pages6
JournalInternational Journal of Stroke
Volume10
Issue numberA100
DOIs
Publication statusPublished - Oct 1 2015

Fingerprint

Meta-Analysis
Stroke
Intracranial Hemorrhages
Brain Ischemia
Hemorrhage
Decision Support Techniques
Platelet Aggregation Inhibitors
Uncertainty
Blood Vessels
Decision Making
Research Personnel
Outcome Assessment (Health Care)
Pharmaceutical Preparations
Therapeutics

Keywords

  • Antiplatelet therapy
  • Aspirin
  • Epidemiology
  • Intracerebral hemorrhage
  • Protocols
  • Vascular events

ASJC Scopus subject areas

  • Neurology

Cite this

Individual patient data meta-analysis of antiplatelet regimens after noncardioembolic stroke or TIA : Rationale and design. / Cerebrovascular Antiplatelet Trialists Collaborative Group.

In: International Journal of Stroke, Vol. 10, No. A100, 01.10.2015, p. 145-150.

Research output: Contribution to journalArticle

Cerebrovascular Antiplatelet Trialists Collaborative Group. / Individual patient data meta-analysis of antiplatelet regimens after noncardioembolic stroke or TIA : Rationale and design. In: International Journal of Stroke. 2015 ; Vol. 10, No. A100. pp. 145-150.
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abstract = "Background: The Cerebrovascular Antiplatelet Trialists' Collaborative Group was formed to obtain and analyze individual patient data from the major randomized trials of common antiplatelet regimens after cerebral ischemia. Although the risk of stroke can be reduced by antiplatelet drugs, there continues to be uncertainty about the balance of risk and benefits of different antiplatelet regimens for an individual patient. Aims: Our aim is to provide clinicians with a thorough evidence-based answer on these therapeutic alternatives. Methods: We have identified six large randomized trials and plan to meta-analyze the data on an individual patient level. In total, these trials have enrolled 46948 patients with cerebral ischemia. Uniquely, the Cerebrovascular Antiplatelet Trialists' Collaborative Group has secured access to the individual data of all of these trials, with the participation of key investigators and pharmaceutical companies. Our principal objective includes deriving a reliable estimate of the efficacy of different antiplatelet regimens on key outcomes including serious vascular events, major ischemic events, major bleeding, and intracranial hemorrhage. Results: We propose to redefine composite outcome events, if necessary, to achieve comparability. Further, we aim to build and validate prognostic models for the risk of major bleeding and intracranial hemorrhage and to build a decision model that may support evidence-based decision making about which antiplatelet regimen would be most effective in different risk groups of patients. Conclusions: This paper outlines inclusion criteria, outcome measures, baseline characteristics, and planned statistical analysis.",
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T1 - Individual patient data meta-analysis of antiplatelet regimens after noncardioembolic stroke or TIA

T2 - Rationale and design

AU - Cerebrovascular Antiplatelet Trialists Collaborative Group

AU - Greving, Jacoba P.

AU - Diener, Hans Christoph

AU - Csiba, L.

AU - Hacke, Werner

AU - Kappelle, L. Jaap

AU - Koudstaal, Peter J.

AU - Leys, Didier

AU - Mas, Jean Louis

AU - Sacco, Ralph L.

AU - Sivenius, Juhani

AU - Algra, Ale

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N2 - Background: The Cerebrovascular Antiplatelet Trialists' Collaborative Group was formed to obtain and analyze individual patient data from the major randomized trials of common antiplatelet regimens after cerebral ischemia. Although the risk of stroke can be reduced by antiplatelet drugs, there continues to be uncertainty about the balance of risk and benefits of different antiplatelet regimens for an individual patient. Aims: Our aim is to provide clinicians with a thorough evidence-based answer on these therapeutic alternatives. Methods: We have identified six large randomized trials and plan to meta-analyze the data on an individual patient level. In total, these trials have enrolled 46948 patients with cerebral ischemia. Uniquely, the Cerebrovascular Antiplatelet Trialists' Collaborative Group has secured access to the individual data of all of these trials, with the participation of key investigators and pharmaceutical companies. Our principal objective includes deriving a reliable estimate of the efficacy of different antiplatelet regimens on key outcomes including serious vascular events, major ischemic events, major bleeding, and intracranial hemorrhage. Results: We propose to redefine composite outcome events, if necessary, to achieve comparability. Further, we aim to build and validate prognostic models for the risk of major bleeding and intracranial hemorrhage and to build a decision model that may support evidence-based decision making about which antiplatelet regimen would be most effective in different risk groups of patients. Conclusions: This paper outlines inclusion criteria, outcome measures, baseline characteristics, and planned statistical analysis.

AB - Background: The Cerebrovascular Antiplatelet Trialists' Collaborative Group was formed to obtain and analyze individual patient data from the major randomized trials of common antiplatelet regimens after cerebral ischemia. Although the risk of stroke can be reduced by antiplatelet drugs, there continues to be uncertainty about the balance of risk and benefits of different antiplatelet regimens for an individual patient. Aims: Our aim is to provide clinicians with a thorough evidence-based answer on these therapeutic alternatives. Methods: We have identified six large randomized trials and plan to meta-analyze the data on an individual patient level. In total, these trials have enrolled 46948 patients with cerebral ischemia. Uniquely, the Cerebrovascular Antiplatelet Trialists' Collaborative Group has secured access to the individual data of all of these trials, with the participation of key investigators and pharmaceutical companies. Our principal objective includes deriving a reliable estimate of the efficacy of different antiplatelet regimens on key outcomes including serious vascular events, major ischemic events, major bleeding, and intracranial hemorrhage. Results: We propose to redefine composite outcome events, if necessary, to achieve comparability. Further, we aim to build and validate prognostic models for the risk of major bleeding and intracranial hemorrhage and to build a decision model that may support evidence-based decision making about which antiplatelet regimen would be most effective in different risk groups of patients. Conclusions: This paper outlines inclusion criteria, outcome measures, baseline characteristics, and planned statistical analysis.

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KW - Intracerebral hemorrhage

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