What does this research mean for the field?

The addition of a second antiplatelet agent did not significantly reduce long-term stroke recurrence or mortality compared to single antiplatelet therapy in acute ischemic stroke patients. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

The aim is to evaluate the long-term outcomes of dual versus single antiplatelet therapy in patients with acute ischemic stroke.

January 10, 2026Open Access

Real-World Comparative Outcomes of Dual vs. Single Antiplatelet Therapy in Acute Ischemic Stroke: A Retrospective Cohort Analysis

Key Result

The addition of a second antiplatelet agent did not significantly reduce long-term stroke recurrence or mortality compared to single antiplatelet therapy in AIS patients.

Key Points

The aim is to evaluate the long-term outcomes of dual versus single antiplatelet therapy in patients with acute ischemic stroke.
Conducted a retrospective cohort analysis of patients with acute ischemic stroke.
Compared outcomes of dual antiplatelet therapy to single antiplatelet therapy.
Followed patients for 12 months to assess stroke recurrence and mortality.
No significant reduction in stroke recurrence was observed with dual antiplatelet therapy.
Mortality rates were similar between the two therapy groups.
Findings suggest that dual therapy may not provide long-term benefits over single therapy.

Structured PICO

Does dual antiplatelet therapy reduce the incidence of net adverse clinical and cerebral events compared to single antiplatelet therapy in patients with acute ischemic stroke?

Population

912 adult patients (≥ 18 years) with a confirmed diagnosis of acute or subacute ischemic stroke, mean age 65.47 years, 35.85% female, in Saudi Arabia.

Intervention

Dual antiplatelet therapy (aspirin plus clopidogrel)

Comparator

Single antiplatelet therapy (aspirin or clopidogrel alone)

Outcome

Incidence of net adverse clinical and cerebral events (NACCEs), defined as a composite of stroke recurrence, hemorrhagic transformation (within 30 days), and/or all-cause mortality within 12 months of the index strokecomposite

The use of dual antiplatelet therapy beyond the acute-to-subacute phase offers no additional long-term benefits compared to single antiplatelet therapy in patients with acute ischemic stroke.

Main Result

Absolute Event Rate: 0% vs 0%

Abstract

The addition of a second antiplatelet agent did not significantly reduce the long-term risk of stroke recurrence or mortality in patients with AIS over a 12-month period. Further studies are needed to assess long-term benefits and risks of DAPT in different stroke subpopulations.

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