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Risks and benefits of adding anti-platelet therapy to warfarin among patients with prosthetic heart valves: a meta-analysis

^a Department of Medicine, London Health Sciences Center, University of Western Ontario, London, Ontario, Canada

View larger version (18K): [in a new window]   Figure 1 Odds ratio plots (logarithmic scale) for thromboembolism according to whether assigned to antiplatetet therapy or control. The center of each line represents the OR for the individual trials and subgroups with the ends of the horizontal line representing the 95% CIs. The solid line represents an OR of 1; to the left of the line (OR < 1) favors antiplatelet therapy, and to the right of the line (OR > 1) favors control or placebo. The broken line and the center of the box represent the pooled OR, and the ends of the horizontal line represent the pooled 95% CI. CI = confidence interval; OR = odds ratio.

View larger version (21K): [in a new window]   Figure 2 Odds ratio plots (logarithmic scale) for total mortality according to whether assigned to antiplatetet therapy or control. The center of each line represents the OR for the individual trials and subgroups with the ends of the horizontal line representing the 95% CIs. The solid line represents an OR of 1; to the left of the line (OR < 1) favors antiplatelet therapy, and to the right of the line (OR > 1) favors control or placebo. The broken line and the center of the box represent the pooled OR, and the ends of the horizontal line represent the pooled 95% CI. CI = confidence interval; OR = odds ratio.

View larger version (21K): [in a new window]   Figure 3 Odds ratio plots (logarithmic scale) for major bleeding according to whether assigned to antiplatetet therapy or control. Data for major bleeding was available for only eight of the trials. The center of each line represents the OR for the individual trials and subgroups with the ends of the horizontal line representing the 95% CI. The solid line represents an OR of 1; to the left of the line (OR < 1) favors antiplatelet therapy, and to the right of the line (OR > 1) favors control or placebo. Statistically significant tests of heterogeneity comparing pre- and post-1990 and early and late aspirin trials are shown. The broken line and the center of the box represent the pooled OR, and the ends of the horizontal line represent the pooled 95% CI. CI = confidence interval; OR = odds ratio.

View larger version (14K): [in a new window]   Figure 4 Cumulative meta-analysis of OR plots (logarithmic scale) for major bleeding according to whether assigned to antiplatelet therapy or control. The center of each line represents the OR for the cumulative trials with the ends of the horizontal line representing the 95% confidence interval. The solid line represents an OR of 1; to the left of the line (OR < 1) favors antiplatelet therapy, and to the right of the line (OR > 1) favors control or placebo. p values are provided for the accumulated trials once conventional statistical significance (p < 0.05) was achieved. OR = odds ratio.