{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T12:26:24Z","timestamp":1788351984988,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T00:00:00Z","timestamp":1716422400000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>One of the most serious complications associated with antiplatelet agents is antiplatelet\u2010associated intracranial hemorrhage (AA\u2010ICH). Desmopressin is a synthetic antidiuretic hormone (ADH) analog. It has been linked to improving patient outcomes in antiplatelet\u2010induced intracranial hemorrhage. The secondary outcomes included the incidence of thrombotic complications and neurological outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A systematic search was conducted on three databases (PubMed, Cochrane, and ClinicalTrials.gov) to find eligible literature that compares desmopressin (DDAVP) versus controls in patients with AA\u2010ICH. The Mantel\u2013Haenszel statistic was used to determine an overall effect estimate for each outcome by calculating the risk ratios and 95% confidence intervals (CI). Heterogeneity was measured using the\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      test. The risk of bias in studies was calculated using the New Castle Ottowa Scale.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Five studies were included in the analysis with a total of 598 patients. DDAVP was associated with a nonsignificant decrease in the risk of hematoma expansion (RR\u00a0=\u00a0.8, 95% CI,.51\u20131.24;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.31,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a044%). It was also associated with a non\u2010significant decrease in the risk of thrombotic events (RR,.83; 95% CI,.25\u20132.76;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.76,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a030%). However, patients in the DDAVP group demonstrated a significant increase in the risk of poor neurological outcomes (RR, 1.31; 95% CI, 1.07\u20131.61;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a0.01,\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u00a0=\u00a00%). The risk of bias assessment showed a moderate to low level of risk.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DDAVP was associated with a nonsignificant decrease in hematoma expansion and thrombotic events. However, it was also associated with a significantly poor neurological outcome in the patients. Thus, until more robust clinical trials are conducted, the use of DDAVP should be considered on a case\u2010to\u2010case basis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.3540","type":"journal-article","created":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T03:30:03Z","timestamp":1716435003000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Safety and efficacy of desmopressin (DDAVP) in preventing hematoma expansion in intracranial hemorrhage associated with antiplatelet drugs use: A systematic review and metaanalysis"],"prefix":"10.1002","volume":"14","author":[{"given":"Faizan","family":"Shahzad","sequence":"first","affiliation":[{"name":"Medical Student Rawalpindi Medical University  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usman","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Department of Medicine Holy Family Hospital  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayesha","family":"Muhammad","sequence":"additional","affiliation":[{"name":"Medical Student Rawalpindi Medical University  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farhan","family":"Shahzad","sequence":"additional","affiliation":[{"name":"Medical Student Rawalpindi Medical University  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed Imam","family":"Naufil","sequence":"additional","affiliation":[{"name":"Department of Medicine Holy Family Hospital  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2545-0142","authenticated-orcid":false,"given":"Mohamad Walid","family":"Sukkari","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Aleppo  Aleppo Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah Bin","family":"Kamran","sequence":"additional","affiliation":[{"name":"Medical Student Rawalpindi Medical University  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Murtaza","sequence":"additional","affiliation":[{"name":"Department of Medicine Holy Family Hospital  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwah Bintay","family":"Khalid","sequence":"additional","affiliation":[{"name":"Medical Student Rawalpindi Medical University  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haroon","family":"Shabbir","sequence":"additional","affiliation":[{"name":"Medical Student Rawalpindi Medical University  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sajeel","family":"Saeed","sequence":"additional","affiliation":[{"name":"Department of Medicine Holy Family Hospital  Rawalpindi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,5,23]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000028243"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/tsaco-2020-000520"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.5551\/jat.RV17022"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(16)30392\u20100"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.crvasa.2013.03.003"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.2174\/1389450118666170329152305"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.emc.2012.06.003"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ene.13193"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/14779072.2019.1651199"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(23)00157-6"},{"key":"e_1_2_11_12_1","unstructured":"Enna S. 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