Anticoagulants versus antiplatelet therapy for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischemic attack
Why the study?
Do oral anticoagulants reduce recurrent stroke and vascular events compared to antiplatelet therapy in patients with nonrheumatic atrial fibrillation and a history of stroke or TIA?
Population
1,371 patients with nonrheumatic atrial fibrillation and a previous TIA or minor ischemic stroke.
Comparison
Oral anticoagulants vs Antiplatelet agents
Design
Meta-analysis, Open label (for SIFA trial)
Follow-up
Mean 2.3 years (EAFT) and 1 year (SIFA)
Authors
Discussion
Loading...
Member takes
Implication
Supports preferring anticoagulants over antiplatelets for secondary prevention in nonrheumatic AF; confirms Level 1 meta-analytic superiority.
Structured PICO
Do oral anticoagulants reduce recurrent stroke and vascular events compared to antiplatelet therapy in patients with nonrheumatic atrial fibrillation and a history of stroke or TIA?
P
Population
1,371 patients (from 2 RCTs: EAFT n=455, SIFA n=916) with nonrheumatic atrial fibrillation (NRAF) and a previous TIA or minor ischemic stroke (within 3 months for EAFT, within 15 days for SIFA).
I
Intervention
Oral anticoagulants (target INR 2.5 to 4.0 in EAFT, INR 2.0 to 3.5 in SIFA)
C
Comparator
Antiplatelet agents (aspirin 300 mg/day in EAFT, indobufen 100 or 200 mg BID in SIFA)
O
Outcome
All vascular events and recurrent strokehard clinical
Oral anticoagulants are superior to antiplatelet therapy for preventing recurrent stroke in patients with nonrheumatic atrial fibrillation and a recent TIA or minor stroke, though they increase extracranial bleeding risk.
Cite This Study
Saxena et al. (2004) studied this question.