Effect of Antiplatelet Therapy on Acute Respiratory Distress Syndrome and Mortality in Critically Ill Patients: A Meta-Analysis

• Published in: PloS one Vol. 11; no. 5; p. e0154754
• Main Authors: Wang, Lijun, Li, Heng, Gu, Xiaofei, Wang, Zhen, Liu, Su, Chen, Liyong
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 16.05.2016; Public Library of Science (PLoS)
• Subjects: Adult respiratory distress syndrome; Analysis; Anesthesiology; Bias; Biology and Life Sciences; Cardiovascular diseases; Care and treatment; Cohort Studies; Comorbidity; Confidence intervals; Critical Illness - epidemiology; Critical Illness - mortality; Dosage and administration; Heart diseases; Hospitals; Humans; Incidence; Lungs; Medicine and Health Sciences; Meta-analysis; Mortality; Neutrophils; Nonsteroidal anti-inflammatory drugs; Odds Ratio; Patient outcomes; Patients; People and Places; Physical Sciences; Physiology; Platelet aggregation inhibitors; Platelet Aggregation Inhibitors - adverse effects; Publication Bias; Research and Analysis Methods; Respiratory distress syndrome; Respiratory Distress Syndrome, Adult - epidemiology; Respiratory Distress Syndrome, Adult - mortality; Sepsis; Studies; Subgroups; Surgery; Systematic review; Therapy; Thrombosis; Trauma; United Kingdom; China
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0154754

Antiplatelet agents are commonly used for cardiovascular diseases, but their pleiotropic effects in critically ill patients are controversial. We therefore performed a meta-analysis of cohort studies to investigate the effect of antiplatelet therapy in the critically ill. Nine cohort studies, retrieved from PubMed and Embase before November 2015, involving 14,612 critically ill patients and 4765 cases of antiplatelet users, were meta-analysed. The main outcome was hospital or 30-day mortality. Secondary outcome was acute respiratory distress syndrome (ARDS) or acute lung injury (ALI). Random- or fixed-effect models were taken for quantitative synthesis of the data. Antiplatelet therapy was associated with decreased mortality (odds ratio (OR) 0.61; 95% confidence interval (CI), 0.52-0.71; I2 = 0%; P <0. 001) and ARDS/ALI (OR 0.64; 95% CI, 0.50-0.82; I2 = 0%; P <0. 001). In every stratum of subgroups, similar findings on mortality reduction were consistently observed in critically ill patients. Antiplatelet therapy is associated with reduced mortality and lower incidence of ARDS/ALI in critically ill patients, particularly those with predisposing conditions such as high-risk surgery, trauma, pneumonia, and sepsis. However, it remains unclear whether similar findings can be observed in the unselected and broad population with critical illness.