title: Antiplatelet Treatment Reduces All-Cause Mortality in COPD Patients: A Systematic Review and Meta-Analysis.
abstract: Previous studies clearly showed that patients with chronic obstructive pulmonary disease (COPD) are at high risk for cardiovascular events. Platelet activation is significantly heightened in these patients, probably because of a chronic inflammatory status. Nevertheless, it is unclear whether antiplatelet treatment may contribute to reduce all-cause mortality in COPD patients. To clarify this issue, we performed a systematic review and meta-analysis including patients with COPD (outpatients or admitted to hospital for acute exacerbation). The primary endpoint was all-cause mortality. We considered studies stratifying the study population according the administration or not of antiplatelet therapy and reporting its relationship with the primary endpoint. Overall, 5 studies including 11117 COPD patients were considered (of those 3069 patients were with acute exacerbation of COPD). IHD was present in 33% of COPD patients [95%CI 31%-35%). Antiplatelet therapy administration was common (47%, 95%CI 46%-48%), ranging from 26% to 61%. Of note, IHD was considered as confounding factor at multivariable analysis in all studies. All-cause mortality was significantly lower in COPD patients receiving antiplatelet treatment (OR 0.81; 95%CI 0.75-0.88). The data was consistent both in outpatients and in those with acute exacerbation of COPD. The pooled studies analysis showed a very low heterogeneity (I(2) : 8%). Additional analyses (meta-regression) showed that antiplatelet therapy administration was effective independently (to potential confounding factors as IHD, cardiovascular drugs and cardiovascular risk factors. In conclusion, our meta-analysis suggested that antiplatelet therapy might significantly contribute to reduce all-cause mortality in COPD patients.
authors.affiliation: a Cardiology Unit , Azienda Ospedaliero-Universitaria S.Anna , Cona (FE) , Italy.
authors.forename: Rita
authors.initials: R
authors.lastname: Pavasini
authors.affiliation: a Cardiology Unit , Azienda Ospedaliero-Universitaria S.Anna , Cona (FE) , Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Biscaglia
authors.affiliation: b Division of Cardiology , Città della Salute e della Scienza , Turin , Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: d'Ascenzo
authors.affiliation: a Cardiology Unit , Azienda Ospedaliero-Universitaria S.Anna , Cona (FE) , Italy.
authors.forename: Annamaria
authors.initials: A
authors.lastname: Del Franco
authors.affiliation: c Research Centre on Asthma and COPD , Section of Internal and Cardio-Respiratory Medicine , University of Ferrara , Ferrara , Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Contoli
authors.affiliation: a Cardiology Unit , Azienda Ospedaliero-Universitaria S.Anna , Cona (FE) , Italy.
authors.forename: Fatima
authors.initials: F
authors.lastname: Zaraket
authors.affiliation: e Cardiology and Arrhythmology Clinic , Marche Polytechnic , University of Ancona , Ancona , Italy.
authors.forename: Federico
authors.initials: F
authors.lastname: Guerra
authors.affiliation: a Cardiology Unit , Azienda Ospedaliero-Universitaria S.Anna , Cona (FE) , Italy.|d Laboratorio per le Tecnologie delle Terapie Avanzate (LTTA) Center , Ferrara , Italy.|f Maria Cecilia Hospital , GVM Care & Research , E.S.: Health Science Foundation , Cotignola , Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Ferrari
authors.affiliation: a Cardiology Unit , Azienda Ospedaliero-Universitaria S.Anna , Cona (FE) , Italy.|d Laboratorio per le Tecnologie delle Terapie Avanzate (LTTA) Center , Ferrara , Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Campo
mesh_terms: D002423:Cause of Death; D006801:Humans; D009026:Mortality; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000150:complications / Q000188:drug therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications
chemical_list: D010975:Platelet Aggregation Inhibitors
keywords: antiplatelet agents; aspirin; chronic obstructive pulmonary disease; mortality