Table 3.
Outcome; timeframe | Study results and measurements | Absolute effect estimates | Certainty in effect estimates (quality of evidence) | Plain text summary | |
---|---|---|---|---|---|
Stop clopidogrel, continue aspirin | Continue clopidogrel and aspirin | ||||
Ischaemic stroke; 90 days | Odds ratio 1.47 (95% CI 0.84 to 2.56). Based on data from 4406 patients in one study. Follow-up 90 days | 10/1000 | 14/1000 | Moderate: due to indirectness* | Longer duration of dual antiplatelet therapy probably does not result in an important reduction in ischaemic stroke |
Difference: 4 more per 1000 (95% CI 2 fewer to 11 more) | |||||
Moderate or severe bleeding; 90 days | Odds ratio 2.20 (95% CI 0.83 to 5.78). Based on data from 4599 patients in one study. Follow-up 90 days | 3/1000 | 6/1000 | High: downgraded due to imprecision and upgraded due to a dose-response gradient † | Longer duration of dual antiplatelet therapy increases risk of moderate or major bleeding by small amount |
Difference: 3 more per 1000 (95% CI 1 fewer to 7 more) |
Indirectness: serious. Patients were randomised 21 days before decision point of whether to stop clopidogrel or not, and patients who had a stroke within the first 21 days were not included in this analysis. More patients randomised to aspirin had a stroke before day 21. Therefore, patients who continued clopidogrel and aspirin were probably at higher risk of a stroke after day 21.
Imprecision: serious. Confidence interval includes no difference.