Anticoagulants versus antiplatelet agents for acute ischaemic stroke
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Why the study?
Do anticoagulants reduce death or dependency compared to antiplatelet agents in patients with acute ischaemic stroke?
Population
16,558 patients from 4 RCTs with presumed or confirmed acute ischaemic stroke, randomized within 14 days of…
Comparison
Anticoagulants, either alone or in combination… vs Antiplatelet agents alone.
Design
Meta-analysis, Truly unconfounded, randomised-controlled trials
Follow-up
long-term follow-up (minimum one month)
Authors
Discussion
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Implication
Anticoagulants confer no long-term functional benefit over aspirin in acute ischemic stroke; reinforces guideline preference for antiplatelet therapy.
Structured PICO
Do anticoagulants reduce death or dependency compared to antiplatelet agents in patients with acute ischaemic stroke?
P
Population
16,558 patients from 4 RCTs with presumed or confirmed acute ischaemic stroke, randomized within 14 days of onset.
I
Intervention
Anticoagulants (unfractionated heparin [UFH] or low molecular-weight heparin [LMWH]), either alone or in combination with antiplatelet agents.
C
Comparator
Antiplatelet agents alone (aspirin was used as control in all trials).
O
Outcome
Death or dependency at long-term follow-up (minimum one month).composite
Anticoagulants offer no net advantages over antiplatelet agents in acute ischaemic stroke, as the increased risk of symptomatic intracranial hemorrhage and death outweighs the reduction in deep vein thrombosis.
Cite This Study
Berge et al. (2002) studied this question.
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