Cochrane · systematic review · CD013573
Pharmacological interventions for asymptomatic carotid stenosis
Clezar, CNB, Flumignan, CDQ, Cassola, N, et al. · Cochrane Database of Systematic Reviews · 2023 · Cochrane Library
StrokeAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
32
current version
GRADE rated
13
No studies
19
Included studies
NR
No studies 19 · 59.4%Ungraded 0 · 0%Very low 2 · 6.3%Low 11 · 34.4%Moderate 0 · 0%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Antiplatelet agent versus placebo for asymptomatic carotid stenosis
Population: asymptomatic carotid stenosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomes (measurement) Antiplatelet agent vs placebo | no estimate extracted | NR | No studies |
Neurological impairment Antiplatelet agent vs placebo | no estimate extracted | NR | No studies |
Ipsilateral major or disabling stroke (CT scan or MRI) Antiplatelet agent vs placebo | RR 1.08 [0.47, 2.47] | 1 study · 372 participants | Low Downgraded: imprecision |
Stroke‐related mortality (CT scan or MRI) Antiplatelet agent vs placebo | RR 1.4 [0.54, 3.59] | 1 study · 372 participants | Low Downgraded: imprecision |
Major bleeding (not reported) Antiplatelet agent vs placebo | RR 0.98 [0.06, 15.53] | 1 study · 372 participants | Very low Downgraded: imprecision, indirectness |
Progression of carotid stenosis (DUS/every 6 months) Antiplatelet agent vs placebo | RR 1.16 [0.79, 1.71] | 1 study · 372 participants | Low Downgraded: imprecision |
Adverse events (not reported) Antiplatelet agent vs placebo | RR 0.81 [0.41, 1.59] | 1 study · 372 participants | Low Downgraded: imprecision |
Quality of life Antiplatelet agent vs placebo | no estimate extracted | NR | No studies |
Antihypertensive agent versus placebo for asymptomatic carotid stenosis
Population: asymptomatic carotid stenosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomes (measurement/time point) Antihypertensive agent vs placebo | no estimate extracted | NR | No studies |
Neurological impairment Antihypertensive agent vs placebo | no estimate extracted | NR | No studies |
Ipsilateral major or disabling stroke (not reported) Antihypertensive agent vs placebo | RR 0.14 [0.02, 1.16] | 1 study · 793 participants | Low Downgraded: imprecision |
Stroke‐related mortality (not reported) Antihypertensive agent vs placebo | RR 0.57 [0.17, 1.94] | 1 study · 793 participants | Low Downgraded: imprecision |
Major bleeding Antihypertensive agent vs placebo | no estimate extracted | NR | No studies |
Progression of carotid stenosis (DUS/at beginning and end) Antihypertensive agent vs placebo | RR 0.45 [0.23, 0.91] | 1 study · 129 participants | Low Downgraded: imprecision |
Adverse events Antihypertensive agent vs placebo | no estimate extracted | NR | No studies |
Quality of life Antihypertensive agent vs placebo | no estimate extracted | NR | No studies |
Anticoagulant agent versus placebo for asymptomatic carotid stenosis
Population: asymptomatic carotid stenosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomes (measurement/time point) Anticoagulant agent vs placebo | no estimate extracted | NR | No studies |
Neurological impairment Anticoagulant agent vs placebo | no estimate extracted | NR | No studies |
Ipsilateral major or disabling stroke Anticoagulant agent vs placebo | no estimate extracted | NR | No studies |
Stroke‐related mortality Anticoagulant agent vs placebo | no estimate extracted | NR | No studies |
Major bleeding (hospital records/every 6 weeks) Anticoagulant agent vs placebo | RR 1.19 [0.97, 1.46] | 1 study · 919 participants | Very low Downgraded: imprecision, indirectness |
Progression of carotid stenosis Anticoagulant agent vs placebo | no estimate extracted | NR | No studies |
Adverse events (hospital records/every 6 weeks) Anticoagulant agent vs placebo | RR 0.89 [0.81, 0.99] | 1 study · 919 participants | Low Downgraded: imprecision, indirectness |
Quality of life Anticoagulant agent vs placebo | no estimate extracted | NR | No studies |
Lipid‐lowering agent compared to placebo or no treatment for asymptomatic carotid stenosis
Population: asymptomatic carotid stenosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Outcomes (measurement/time point) Lipid‐lowering agent vs placebo or no treatment | no estimate extracted | NR | No studies |
Neurological impairment Lipid‐lowering agent vs placebo or no treatment | no estimate extracted | NR | No studies |
Ipsilateral major or disabling stroke (only reported for two studies: one used CT scan, MRI and hospital records/every 6 weeksb; the other used physical examination/at beginning and 10 days after the endc) Lipid‐lowering agent vs placebo or no treatment | RR 0.36 [0.09, 1.53] | 5 studies · 2235 participants | Low Downgraded: imprecision |
Stroke‐related mortality (only reported for one study: CT scan, MRI and hospital records/every 6 weeksb) Lipid‐lowering agent vs placebo or no treatment | RR 0.25 [0.03, 2.29] | 2 studies · 1366 participants | Low Downgraded: imprecision |
Major bleeding Lipid‐lowering agent vs placebo or no treatment | no estimate extracted | NR | No studies |
Progression of carotid stenosis Lipid‐lowering agent vs placebo or no treatment | no estimate extracted | NR | No studies |
Adverse events (only reported for two studies: one study used CT scan, MRI and hospital records/every 6 weeksb; the other used physical examination/at beginning and 10 days after the endc) Lipid‐lowering agent vs placebo or no treatment | RR 0.76 [0.53, 1.1] | 7 studies · 3726 participants | Low Downgraded: imprecision |
Quality of life Lipid‐lowering agent vs placebo or no treatment | no estimate extracted | NR | No studies |