Key result
DAPT is linked to a ~44% lower risk of recurrent stroke, MI, or death vs SAPT.
Why the study?
The study aimed to evaluate the efficacy and safety of dual antiplatelet therapy versus single antiplatelet therapy for patients with a first-ever embolic stroke of undetermined source.
Does dual antiplatelet therapy reduce the composite of recurrent ischemic stroke, myocardial infarction, or all-cause death in patients with first-ever embolic stroke of undetermined source compared to single antiplatelet therapy?
Population
1675 patients with a first-ever embolic stroke of undetermined source
Comparison
DAPT vs SAPT
Design
Multicenter cohort study with propensity score matching
Follow-up
Median 2.6 years (extended to 3 years)
Authors
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Hypothesis-generating for DAPT in ESUS; randomized trials needed before clinical adoption.
Cohort (n=1,675)
Yes
Does dual antiplatelet therapy reduce the composite of recurrent ischemic stroke, myocardial infarction, or all-cause death in patients with first-ever embolic stroke of undetermined source compared to single antiplatelet therapy?
Effect estimate: HR 0.56 (95% CI 0.44-0.70)
Absolute Event Rate: 5.5% vs 10.1%
In patients with first-ever embolic stroke of undetermined source, dual antiplatelet therapy was associated with a significantly lower risk of recurrent ischemic events and mortality compared to single antiplatelet therapy, without an increase in major bleeding.
Lee et al. (2025) conducted a cohort in First-ever embolic stroke of undetermined source (ESUS) (n=1,675). Dual antiplatelet therapy (DAPT) vs. Single antiplatelet therapy (SAPT) was evaluated on Composite of recurrent ischemic stroke, myocardial infarction, or all-cause death (HR 0.56, 95% CI 0.44-0.70). Dual antiplatelet therapy was associated with a lower hazard of recurrent ischemic stroke, myocardial infarction, or death compared to single antiplatelet therapy (HR 0.56; 95% CI 0.44-0.70).
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