Antiplatelet Therapy for Critically Ill Patients: A Pairwise and Bayesian Network Meta-Analysis

Area of Science:

• Critical Care Medicine
• Pharmacology
• Evidence-Based Medicine

Background:

• Antiplatelet therapy is a potential treatment for critically ill patients.
• Further evidence is needed to confirm its benefits in this population.

Purpose of the Study:

• To evaluate the efficacy of antiplatelet therapy in critically ill patients through a meta-analysis.
• To identify specific patient subgroups and antiplatelet agents that offer the most significant benefits.

Main Methods:

• A comprehensive search of PubMed and Embase databases was conducted up to June 2017.
• Included randomized controlled trials and observational studies assessing antiplatelet therapy in critically ill patients.
• Network meta-analysis was employed to compare different antiplatelet agents.

Main Results:

• Antiplatelet therapy significantly decreased hospital mortality (RR 0.81), ICU mortality (RR 0.78), acute lung injury incidence (RR 0.73), and sepsis incidence (RR 0.81).
• Benefits were primarily observed in septic patients, with significant reductions in hospital (RR 0.71) and ICU mortality (RR 0.65).
• Network meta-analysis indicated aspirin as the most probable agent for reducing hospital mortality.

Conclusions:

• Antiplatelet therapy is beneficial for critically ill patients, particularly those with sepsis.
• Aspirin appears to be the most effective antiplatelet agent for reducing hospital mortality in this cohort.