Key result
Antiplatelet therapy is linked to ~35% lower mortality in hospitalized community-acquired pneumonia.
Why the study?
Antiplatelet agents may favorably modulate inflammatory and thrombotic pathways in community-acquired pneumonia, but their role in non-COVID-19 CAP remains uncertain.
Do antiplatelet agents reduce mortality in hospitalized adult patients with non-COVID-19 community-acquired pneumonia?
Meta-Analysis (n=123,237)
Yes
Do antiplatelet agents reduce mortality in hospitalized adult patients with non-COVID-19 community-acquired pneumonia?
Antiplatelet agents may be associated with reduced mortality in hospitalized patients with non-COVID-19 community-acquired pneumonia, though current evidence is of low certainty and requires confirmation by high-quality RCTs.
Answers are grounded in this paper and cite their sources.
May support antiplatelet consideration in non-COVID CAP but should not change practice; low-certainty meta-analysis leaves open need for RCTs.
Background: Community-acquired pneumonia (CAP) triggers inflammatory and thrombotic host responses driving morbidity and mortality. Antiplatelet agents may favorably modulate these pathways; however, their role in non-COVID-19 CAP remains uncertain. Objectives: To evaluate the association of antiplatelet agents with mortality in hospitalized patients with non-COVID-19 CAP. Methods: We conducted a systematic review and meta-analysis of observational studies and randomized controlled trials (RCTs) of adult patients hospitalized for non-COVID-19 CAP exposed to antiplatelet agents (acetylsalicylic acid or P2Y12 inhibitors). We searched MEDLINE, Embase, and CENTRAL from inception to August 2023. Our primary outcome was all-cause mortality: meta-analyzed (random-effects models) separately for observational studies and RCTs. For observational studies, we used adjusted mortality estimates. Results: = 54%; 2 studies, 225 patients). By the Grading of Recommendations, Assessment, Development, and Evaluation criteria, the certainty of the evidence was low, primarily due to risk of bias. Conclusion: In hospitalized patients with non-COVID-19 CAP, antiplatelet agents may be associated with reduced mortality compared with usual care or placebo, but the certainty of evidence is low.
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Lother et al. (2024) conducted a meta-analysis in Non-COVID-19 community-acquired pneumonia (n=123,237). Antiplatelet agents (acetylsalicylic acid or P2Y12 inhibitors) vs. Usual care or placebo was evaluated on All-cause mortality at longest follow-up (HR 0.65, 95% CI 0.46-0.91). In hospitalized patients with non-COVID-19 community-acquired pneumonia, exposure to antiplatelet agents was associated with a 35% lower adjusted hazard of death (HR 0.65) compared with usual care, though the certainty of evidence was low.
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