Why the study?
What is the optimal antithrombotic strategy for secondary prevention of cerebral ischaemia in patients with and without atrial fibrillation?
What is the optimal antithrombotic strategy for secondary prevention of cerebral ischaemia in patients with and without atrial fibrillation?
Oral anticoagulation is recommended for secondary stroke prevention in patients with atrial fibrillation, while aspirin plus dipyridamole is preferred for those without a cardiac source of embolism.
Endorses differential antithrombotic regimens by AF status for secondary stroke prevention; leaves open comparative efficacy versus contemporary agents in updated trials.
In this paper, an overview is given of trials with oral anticoagulants and dipyridamole in the secondary prevention after transient ischaemic attack or minor stroke. In patients with atrial fibrillation, the secondary preventive treatment of first choice is oral anticoagulation with an aimed international normalised ratio between 2.0 and 3.0. In patients without a cardiac source of embolism, a combination therapy of low-dose aspirin and dipyridamole 200 mg twice daily is the treatment of choice. These treatment strategies do however not prevent all recurrent strokes or vascular complications, and research for more effective strategies is warranted.
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Halkes et al. (2007) studied this question.
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