Scolaris Content Display Scolaris Content Display

Study flow diagram.
Figures and Tables -
Figure 1

Study flow diagram.

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Antiplatelet agent versus placebo, Outcome 1 All cause mortality.
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Analysis 1.1

Comparison 1 Antiplatelet agent versus placebo, Outcome 1 All cause mortality.

Comparison 1 Antiplatelet agent versus placebo, Outcome 2 Cardiovascular mortality (fatal stroke or MI).
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Analysis 1.2

Comparison 1 Antiplatelet agent versus placebo, Outcome 2 Cardiovascular mortality (fatal stroke or MI).

Comparison 1 Antiplatelet agent versus placebo, Outcome 3 Cardiovascular event (fatal and non‐fatal MI or stroke).
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Analysis 1.3

Comparison 1 Antiplatelet agent versus placebo, Outcome 3 Cardiovascular event (fatal and non‐fatal MI or stroke).

Comparison 1 Antiplatelet agent versus placebo, Outcome 4 Myocardial infarction (fatal and non‐fatal).
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Analysis 1.4

Comparison 1 Antiplatelet agent versus placebo, Outcome 4 Myocardial infarction (fatal and non‐fatal).

Comparison 1 Antiplatelet agent versus placebo, Outcome 5 Myocardial infarction (fatal).
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Analysis 1.5

Comparison 1 Antiplatelet agent versus placebo, Outcome 5 Myocardial infarction (fatal).

Comparison 1 Antiplatelet agent versus placebo, Outcome 6 Myocardial infarction (non‐fatal).
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Analysis 1.6

Comparison 1 Antiplatelet agent versus placebo, Outcome 6 Myocardial infarction (non‐fatal).

Comparison 1 Antiplatelet agent versus placebo, Outcome 7 Stroke (fatal and non‐fatal).
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Analysis 1.7

Comparison 1 Antiplatelet agent versus placebo, Outcome 7 Stroke (fatal and non‐fatal).

Comparison 1 Antiplatelet agent versus placebo, Outcome 8 Stroke (fatal).
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Analysis 1.8

Comparison 1 Antiplatelet agent versus placebo, Outcome 8 Stroke (fatal).

Comparison 1 Antiplatelet agent versus placebo, Outcome 9 Stroke (non‐fatal).
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Analysis 1.9

Comparison 1 Antiplatelet agent versus placebo, Outcome 9 Stroke (non‐fatal).

Comparison 1 Antiplatelet agent versus placebo, Outcome 10 Major bleeding.
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Analysis 1.10

Comparison 1 Antiplatelet agent versus placebo, Outcome 10 Major bleeding.

Comparison 1 Antiplatelet agent versus placebo, Outcome 11 GI symptoms (dyspepsia).
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Analysis 1.11

Comparison 1 Antiplatelet agent versus placebo, Outcome 11 GI symptoms (dyspepsia).

Comparison 1 Antiplatelet agent versus placebo, Outcome 12 Early cessation of treatment.
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Analysis 1.12

Comparison 1 Antiplatelet agent versus placebo, Outcome 12 Early cessation of treatment.

Comparison 1 Antiplatelet agent versus placebo, Outcome 13 Pain Free Walking Distance.
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Analysis 1.13

Comparison 1 Antiplatelet agent versus placebo, Outcome 13 Pain Free Walking Distance.

Comparison 1 Antiplatelet agent versus placebo, Outcome 14 Revascularisation.
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Analysis 1.14

Comparison 1 Antiplatelet agent versus placebo, Outcome 14 Revascularisation.

Comparison 1 Antiplatelet agent versus placebo, Outcome 15 Limb amputations.
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Analysis 1.15

Comparison 1 Antiplatelet agent versus placebo, Outcome 15 Limb amputations.

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 1 All cause mortality.
Figures and Tables -
Analysis 2.1

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 1 All cause mortality.

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 2 Cardiovascular mortality (fatal stroke or MI).
Figures and Tables -
Analysis 2.2

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 2 Cardiovascular mortality (fatal stroke or MI).

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 3 Cardiovascular event (fatal and non‐fatal MI or stroke).
Figures and Tables -
Analysis 2.3

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 3 Cardiovascular event (fatal and non‐fatal MI or stroke).

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 4 Myocardial infarction (fatal and non‐fatal).
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Analysis 2.4

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 4 Myocardial infarction (fatal and non‐fatal).

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 5 Myocardial infarction (fatal).
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Analysis 2.5

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 5 Myocardial infarction (fatal).

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 6 Myocardial infarction (non‐fatal).
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Analysis 2.6

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 6 Myocardial infarction (non‐fatal).

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 7 Stroke (fatal and non‐fatal).
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Analysis 2.7

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 7 Stroke (fatal and non‐fatal).

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 8 Stroke (fatal).
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Analysis 2.8

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 8 Stroke (fatal).

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 9 Stroke (non‐fatal).
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Analysis 2.9

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 9 Stroke (non‐fatal).

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 10 Major bleeding.
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Analysis 2.10

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 10 Major bleeding.

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 11 GI symptoms (dyspepsia).
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Analysis 2.11

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 11 GI symptoms (dyspepsia).

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 12 Early cessation of treatment.
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Analysis 2.12

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 12 Early cessation of treatment.

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 13 Amputation.
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Analysis 2.13

Comparison 2 Antiplatelet agent(s) versus aspirin, Outcome 13 Amputation.

Comparison 1. Antiplatelet agent versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 All cause mortality Show forest plot

5

3926

Risk Ratio (M‐H, Fixed, 95% CI)

0.76 [0.60, 0.98]

1.1 picotamide

1

2304

Risk Ratio (M‐H, Fixed, 95% CI)

0.91 [0.50, 1.66]

1.2 ticlopidine

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.56, 0.96]

2 Cardiovascular mortality (fatal stroke or MI) Show forest plot

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

0.54 [0.32, 0.93]

2.1 ticlopidine

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

0.54 [0.32, 0.93]

3 Cardiovascular event (fatal and non‐fatal MI or stroke) Show forest plot

5

3926

Risk Ratio (M‐H, Fixed, 95% CI)

0.80 [0.63, 1.01]

3.1 picotamide

1

2304

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.47, 1.50]

3.2 ticlopidine

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

0.79 [0.61, 1.02]

4 Myocardial infarction (fatal and non‐fatal) Show forest plot

5

3926

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.63, 1.12]

4.1 picotamide

1

2304

Risk Ratio (M‐H, Fixed, 95% CI)

0.82 [0.39, 1.69]

4.2 ticlopidine

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

0.85 [0.62, 1.16]

5 Myocardial infarction (fatal) Show forest plot

4

1622

Risk Ratio (M‐H, Random, 95% CI)

0.57 [0.31, 1.05]

5.1 ticlopidine

4

1622

Risk Ratio (M‐H, Random, 95% CI)

0.57 [0.31, 1.05]

6 Myocardial infarction (non‐fatal) Show forest plot

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.69, 1.48]

6.1 ticlopidine

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.69, 1.48]

7 Stroke (fatal and non‐fatal) Show forest plot

5

3926

Risk Ratio (M‐H, Fixed, 95% CI)

0.71 [0.45, 1.13]

7.1 picotamide

1

2304

Risk Ratio (M‐H, Fixed, 95% CI)

0.89 [0.35, 2.30]

7.2 ticlopidine

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

0.66 [0.39, 1.12]

8 Stroke (fatal) Show forest plot

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.07, 1.64]

8.1 ticlopidine

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

0.33 [0.07, 1.64]

9 Stroke (non‐fatal) Show forest plot

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.42, 1.30]

9.1 ticlopidine

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.42, 1.30]

10 Major bleeding Show forest plot

2

838

Risk Ratio (M‐H, Fixed, 95% CI)

1.73 [0.51, 5.83]

10.1 ticlopidine

2

838

Risk Ratio (M‐H, Fixed, 95% CI)

1.73 [0.51, 5.83]

11 GI symptoms (dyspepsia) Show forest plot

9

3818

Risk Ratio (M‐H, Random, 95% CI)

2.11 [1.23, 3.61]

11.1 indobufen

2

352

Risk Ratio (M‐H, Random, 95% CI)

3.29 [1.17, 9.27]

11.2 picotamide

2

2344

Risk Ratio (M‐H, Random, 95% CI)

0.94 [0.75, 1.18]

11.3 ticlopidine

4

1000

Risk Ratio (M‐H, Random, 95% CI)

2.40 [1.82, 3.17]

11.4 trifusal

1

122

Risk Ratio (M‐H, Random, 95% CI)

6.41 [0.79, 51.64]

12 Early cessation of treatment Show forest plot

8

4388

Risk Ratio (M‐H, Fixed, 95% CI)

2.05 [1.53, 2.75]

12.1 indobufen

1

300

Risk Ratio (M‐H, Fixed, 95% CI)

1.46 [0.47, 4.49]

12.2 picotamide

2

2344

Risk Ratio (M‐H, Fixed, 95% CI)

1.45 [0.73, 2.84]

12.3 ticlopidine

4

1622

Risk Ratio (M‐H, Fixed, 95% CI)

2.35 [1.66, 3.31]

12.4 trifusal

1

122

Risk Ratio (M‐H, Fixed, 95% CI)

1.07 [0.07, 16.69]

13 Pain Free Walking Distance Show forest plot

3

329

Mean Difference (IV, Random, 95% CI)

78.09 [12.24, 143.95]

13.1 indobufen

2

294

Mean Difference (IV, Random, 95% CI)

196.87 [‐85.58, 479.32]

13.2 picotamide

1

35

Mean Difference (IV, Random, 95% CI)

38.70 [2.68, 74.72]

14 Revascularisation Show forest plot

5

3304

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.43, 0.97]

14.1 picotamide

1

2304

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.50, 1.23]

14.2 ticlopidine

4

1000

Risk Ratio (M‐H, Fixed, 95% CI)

0.34 [0.13, 0.84]

15 Limb amputations Show forest plot

2

2991

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.38, 1.86]

15.1 picotamide

1

2304

Risk Ratio (M‐H, Fixed, 95% CI)

0.80 [0.22, 2.98]

15.2 ticlopidine

1

687

Risk Ratio (M‐H, Fixed, 95% CI)

0.86 [0.32, 2.35]

Figures and Tables -
Comparison 1. Antiplatelet agent versus placebo
Comparison 2. Antiplatelet agent(s) versus aspirin

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 All cause mortality Show forest plot

2

7661

Risk Ratio (M‐H, Fixed, 95% CI)

0.73 [0.58, 0.93]

1.1 clopidogrel vs aspirin

1

6452

Risk Ratio (M‐H, Fixed, 95% CI)

0.78 [0.60, 1.02]

1.2 picotamide vs aspirin

1

1209

Risk Ratio (M‐H, Fixed, 95% CI)

0.55 [0.31, 0.98]

2 Cardiovascular mortality (fatal stroke or MI) Show forest plot

2

7661

Risk Ratio (M‐H, Fixed, 95% CI)

0.74 [0.48, 1.15]

2.1 clopidogrel vs aspirin

1

6452

Risk Ratio (M‐H, Fixed, 95% CI)

0.83 [0.51, 1.35]

2.2 picotamide vs aspirin

1

1209

Risk Ratio (M‐H, Fixed, 95% CI)

0.46 [0.16, 1.31]

3 Cardiovascular event (fatal and non‐fatal MI or stroke) Show forest plot

2

7661

Risk Ratio (M‐H, Fixed, 95% CI)

0.81 [0.67, 0.98]

3.1 clopidogrel vs aspirin

1

6452

Risk Ratio (M‐H, Fixed, 95% CI)

0.79 [0.64, 0.97]

3.2 picotamide vs aspirin

1

1209

Risk Ratio (M‐H, Fixed, 95% CI)

0.94 [0.57, 1.54]

4 Myocardial infarction (fatal and non‐fatal) Show forest plot

2

7661

Risk Ratio (M‐H, Fixed, 95% CI)

0.66 [0.50, 0.86]

4.1 clopidogrel vs aspirin

1

6452

Risk Ratio (M‐H, Fixed, 95% CI)

0.63 [0.47, 0.85]

4.2 picotamide vs aspirin

1

1209

Risk Ratio (M‐H, Fixed, 95% CI)

0.79 [0.41, 1.55]

5 Myocardial infarction (fatal) Show forest plot

2

7661

Risk Ratio (M‐H, Fixed, 95% CI)

0.68 [0.40, 1.15]

5.1 clopidogrel vs aspirin

1

6452

Risk Ratio (M‐H, Fixed, 95% CI)

0.67 [0.37, 1.21]

5.2 picotamide vs aspirin

1

1209

Risk Ratio (M‐H, Fixed, 95% CI)

0.72 [0.23, 2.25]

6 Myocardial infarction (non‐fatal) Show forest plot

2

7661

Risk Ratio (M‐H, Fixed, 95% CI)

0.65 [0.47, 0.89]

6.1 clopidogrel vs aspirin

1

6452

Risk Ratio (M‐H, Fixed, 95% CI)

0.62 [0.44, 0.88]

6.2 picotamide vs aspirin

1

1209

Risk Ratio (M‐H, Fixed, 95% CI)

0.84 [0.36, 1.92]

7 Stroke (fatal and non‐fatal) Show forest plot

2

7661

Risk Ratio (M‐H, Fixed, 95% CI)

1.01 [0.76, 1.34]

7.1 clopidogrel vs aspirin

1

6452

Risk Ratio (M‐H, Fixed, 95% CI)

0.99 [0.73, 1.34]

7.2 picotamide vs aspirin

1

1209

Risk Ratio (M‐H, Fixed, 95% CI)

1.17 [0.55, 2.51]

8 Stroke (fatal) Show forest plot

2

7661

Risk Ratio (M‐H, Random, 95% CI)

0.57 [0.05, 6.44]

8.1 clopidogrel vs aspirin

1

6452

Risk Ratio (M‐H, Random, 95% CI)

1.38 [0.55, 3.42]

8.2 picotamide vs aspirin

1

1209

Risk Ratio (M‐H, Random, 95% CI)

0.11 [0.01, 2.07]

9 Stroke (non‐fatal) Show forest plot

2

7661

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.76, 1.39]

9.1 picotamide vs aspirin

1

1209

Risk Ratio (M‐H, Fixed, 95% CI)

1.76 [0.74, 4.16]

9.2 clopidogrel vs aspirin

1

6452

Risk Ratio (M‐H, Fixed, 95% CI)

0.95 [0.69, 1.31]

10 Major bleeding Show forest plot

1

Risk Ratio (M‐H, Random, 95% CI)

Totals not selected

10.1 picotamide vs aspirin

1

Risk Ratio (M‐H, Random, 95% CI)

0.0 [0.0, 0.0]

11 GI symptoms (dyspepsia) Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

11.1 picotamide vs aspirin

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

12 Early cessation of treatment Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

12.1 picotamide vs aspirin

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

13 Amputation Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

13.1 picotamide vs aspirin

1

Risk Ratio (M‐H, Fixed, 95% CI)

0.0 [0.0, 0.0]

Figures and Tables -
Comparison 2. Antiplatelet agent(s) versus aspirin