Key result
In ICH survivors with AF, VKAs were associated with lower ischemic stroke rates than antiplatelet agents (RR 0.45; 95% CI 0.27-0.74; p=0.002) without significantly increasing ICH recurrence.
Why the study?
Do vitamin K antagonists reduce ischemic stroke compared to antiplatelet agents or no antithrombotic medication in intracranial hemorrhage survivors with atrial fibrillation?
Meta-Analysis (n=2,452)
Do vitamin K antagonists reduce ischemic stroke compared to antiplatelet agents or no antithrombotic medication in intracranial hemorrhage survivors with atrial fibrillation?
Relative Risk: 0.45 (95% CI 0.27–0.74)
p-value: p=0.002
In ICH survivors with AF, anticoagulation with VKAs is associated with a lower rate of ischemic stroke without significantly increasing ICH recurrence compared to antiplatelets or no therapy.
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VKA anticoagulation was associated with lower ischemic stroke rates without significantly increased recurrent ICH in observational data; leaves open net clinical benefit pending RCTs.
Korompoki et al. (2017) conducted a meta-analysis in Intracranial hemorrhage (ICH) survivors with atrial fibrillation (AF) (n=2,452). Vitamin K antagonists (VKAs) vs. Antiplatelet agents (APAs) or no antithrombotic medication (no-ATM) was evaluated on Ischemic stroke (IS) (RR 0.45, 95% CI 0.27-0.74, p=0.002). In ICH survivors with AF, VKAs were associated with lower ischemic stroke rates than antiplatelet agents (RR 0.45; 95% CI 0.27-0.74; p=0.002) without significantly increasing ICH recurrence.
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