Key result
DAPT after ischemic stroke linked to ~39% lower 1-year all-cause mortality versus SAPT.
Why the study?
Antiplatelet therapy is key for preventing morbidity and mortality after ischaemic stroke, but real-world outcomes comparing SAPT and DAPT identified using a novel method required evaluation.
Does dual antiplatelet therapy reduce mortality and major adverse cardiovascular events compared to single antiplatelet therapy in adults after a non-cardioembolic ischemic stroke?
Population
14,469 adults with NCIS post-ischaemic stroke hospitalisation
Comparison
SAPT vs DAPT during the 90-day period post-IS
Design
Retrospective cohort study
Follow-up
1 year
Authors
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Real-world SAPT and DAPT showed comparable outcomes after NCIS; leaves open optimal long-term regimen selection pending RCTs.
Cohort (n=14,469)
Yes
Does dual antiplatelet therapy reduce mortality and major adverse cardiovascular events compared to single antiplatelet therapy in adults after a non-cardioembolic ischemic stroke?
Effect estimate: ATE -1.5% (95% CI -2.0 to -0.8)
Absolute Event Rate: 2.3% vs 3.8%
In a real-world cohort of patients with non-cardioembolic ischemic stroke, DAPT was associated with a lower 1-year incidence of all-cause death and MACE but increased major bleeding compared to SAPT.
Head et al. (2026) conducted a cohort in Ischaemic stroke (n=14,469). Dual antiplatelet therapy (DAPT) vs. Single antiplatelet therapy (SAPT) was evaluated on 1-year incidence of all-cause death (ATE -1.5%, 95% CI -2.0 to -0.8). Dual antiplatelet therapy after ischaemic stroke was associated with a lower 1-year incidence of all-cause death compared to single antiplatelet therapy (2.3% vs 3.8%; ATE -1.5%, 95% CI -2.0 to -0.8).
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