Antiplatelet Treatment Reduces All-Cause Mortality in COPD Patients: A Systematic Review and Meta-Analysis |
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Authors: | Rita Pavasini Simone Biscaglia Fabrizio d'Ascenzo Annamaria Del Franco Marco Contoli Fatima Zaraket |
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Affiliation: | 1. Cardiology Unit, Azienda Ospedaliero-Universitaria S.Anna, Cona (FE), Italypvsrti@unife.it;3. Cardiology Unit, Azienda Ospedaliero-Universitaria S.Anna, Cona (FE), Italy;4. Division of Cardiology, Città della Salute e della Scienza, Turin, Italy;5. Research Centre on Asthma and COPD, Section of Internal and Cardio-Respiratory Medicine, University of Ferrara, Ferrara, Italy |
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Abstract: | Previous studies clearly showed that patients with chronic obstructive pulmonary disease (COPD) are at high risk for cardiovascular events. Platelet activation is significantly heightened in these patients, probably because of a chronic inflammatory status. Nevertheless, it is unclear whether antiplatelet treatment may contribute to reduce all-cause mortality in COPD patients. To clarify this issue, we performed a systematic review and meta-analysis including patients with COPD (outpatients or admitted to hospital for acute exacerbation). The primary endpoint was all-cause mortality. We considered studies stratifying the study population according the administration or not of antiplatelet therapy and reporting its relationship with the primary endpoint. Overall, 5 studies including 11117 COPD patients were considered (of those 3069 patients were with acute exacerbation of COPD). IHD was present in 33% of COPD patients 95%CI 31%–35%). Antiplatelet therapy administration was common (47%, 95%CI 46%–48%), ranging from 26% to 61%. Of note, IHD was considered as confounding factor at multivariable analysis in all studies. All-cause mortality was significantly lower in COPD patients receiving antiplatelet treatment (OR 0.81; 95%CI 0.75–0.88). The data was consistent both in outpatients and in those with acute exacerbation of COPD. The pooled studies analysis showed a very low heterogeneity (I2 : 8%). Additional analyses (meta-regression) showed that antiplatelet therapy administration was effective independently (to potential confounding factors as IHD, cardiovascular drugs and cardiovascular risk factors. In conclusion, our meta-analysis suggested that antiplatelet therapy might significantly contribute to reduce all-cause mortality in COPD patients. |
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Keywords: | aspirin antiplatelet agents chronic obstructive pulmonary disease mortality |
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