BACKGROUND: Antiplatelet drugs are effective and safe in a wide variety of @entity1 at high risk of vascular ischaemic events. Among @entity1 undergoing vascular surgical procedures, these agents significantly reduce the risk of graft or native vessel occlusion. In this context we wished to examine their effects in @entity1 after carotid endarterectomy (CEA). OBJECTIVES: The objective of this review was to evaluate whether antiplatelet agents are safe and beneficial after endarterectomy of the internal carotid artery. SEARCH STRATEGY: We searched the Cochrane @entity64 Group Trials Register (last searched: 1 October 2002). In addition we performed comprehensive searches of the Cochrane Controlled Trials Register (Cochrane Library Issue 3, 2002), MEDLINE (January 1966 to September 2002) and EMBASE (January 1980 to September 2002), and checked all relevant papers for additional eligible studies. SELECTION CRITERIA: We selected randomised, controlled, unconfounded trials comparing antiplatelet agents with control after carotid endarterectomy in symptomatic or asymptomatic @entity543 of different degrees. Treatment duration had to be at least 30 days after CEA. Follow-up should be at least three months. DATA COLLECTION AND ANALYSIS: Two reviewers selected trials for inclusion, assessed trial quality, and extracted data independently from each other. From each trial we extracted, first the number of @entity1 originally allocated to each treatment group, and, second the number of @entity1 who met the criteria for each outcome (intention-to-treat analysis). We calculated a weighted estimate of the odds for each outcome event across studies using the Peto odds ratio method. MAIN RESULTS: Six trials involving 907 @entity1 were identified. For ' @entity204 (all causes)' the Peto odds ratio of 0.77 with a 95% confidence interval (CI) of 0.48-1.24 did not show a statistically significant difference between both treatment groups. For ' @entity64 (any)' the Peto odds ratio of 0.58 (95%CI: 0.34-0.98) indicated a statistically significant benefit in favour of antiplatelet drugs (p=0.04). Concerning the secondary outcome events ' @entity204 ', ' @entity64 or @entity204 ', 'serious vascular events', ' @entity204 or dependency', ' @entity583 ', 'major extracranial @entity548 ', 'local @entity548 requiring surgery', 'restenosis', ' @entity4905 or @entity1939 fugax', neither any benefit nor any hazard of antiplatelet drugs could be shown. For the outcome events ' @entity932 ', ' @entity64 ' and 'occurrence or progression of @entity850 ', data were either too sparse for meaningful analyses, or not available at all. REVIEWER'S CONCLUSIONS: Our results may indicate that antiplatelet drugs did not significantly change the odds of ' @entity204 ' but reduce the outcome ' @entity64 of any cause' in @entity1 undergoing carotid endarterectomy. However, it can not be excluded that the beneficial effect in reducing @entity64 is due to chance. There is a suggestion that antiplatelets may increase the odds of @entity548 , but there are currently too few data to quantify this effect.

Antiplatelet therapy for preventing XXXX and other vascular events after carotid endarterectomy.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke', 'ischaemic stroke', 'Stroke'] @entity932 :: ('MESH:D020300', 'Disease') :: ['intracranial haemorrhage'] @entity548 :: ('MESH:D006470', 'Disease') :: ['haemorrhage'] @entity1939 :: ('MESH:D001766', 'Disease') :: ['amaurosis'] @entity4905 :: ('MESH:D002546', 'Disease') :: ['TIA'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity850 :: ('MESH:D003251', 'Disease') :: ['contralateral stenosis'] @entity204 :: ('MESH:D003643', 'Disease') :: ['vascular death', 'death'] @entity543 :: ('MESH:D016893', 'Disease') :: ['carotid stenosis']
@entity64 :: (MESH:D020521,Disease) :: ['stroke']
