Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source
Why the study?
Does dabigatran prevent recurrent stroke compared to aspirin in patients with a recent history of embolic stroke of undetermined source?
Population
Patients with a recent history of embolic stroke of undetermined source
Comparison
Dabigatran vs aspirin
Authors
Discussion
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Implication
Dabigatran should not supplant aspirin for secondary prevention after embolic stroke of undetermined source; reinforces consensus against its routine use.
Key Points
- To determine whether dabigatran is superior to aspirin in preventing recurrent stroke among patients with a recent embolic stroke of undetermined source.
- Randomized clinical trial (RE-SPECT ESUS, NCT02239120) comparing dabigatran to aspirin.
- Conducted in patients with a recent history of embolic stroke of undetermined source (ESUS).
- Dabigatran was not superior to aspirin in reducing the risk of recurrent stroke.
- The incidence of major bleeding was not significantly greater with dabigatran than with aspirin.
- Clinically relevant nonmajor bleeding events occurred significantly more often in the dabigatran group than in the aspirin group.
Structured PICO
Does dabigatran prevent recurrent stroke compared to aspirin in patients with a recent history of embolic stroke of undetermined source?
P
Population
Patients with a recent history of embolic stroke of undetermined source
I
Intervention
Dabigatran
C
Comparator
Aspirin
O
Outcome
Recurrent strokehard clinical
In patients with a recent embolic stroke of undetermined source, dabigatran was not superior to aspirin for secondary stroke prevention and was associated with more clinically relevant nonmajor bleeding.
Cite This Study
Diener et al. (2019) studied this question.