Key result
Oral anticoagulants did not reduce recurrent ischemic stroke compared to antiplatelets (RR 0.91; 95% CI 0.70-1.18) in patients with stroke and supracardiac atherosclerosis, but increased major bleeding.
Why the study?
The comparative efficacy and safety of oral anticoagulants versus antiplatelets in patients with stroke and supracardiac atherosclerosis was unclear.
Do oral anticoagulants reduce recurrent ischemic stroke in patients with stroke/TIA and supracardiac atherosclerosis compared to antiplatelets?
Meta-Analysis (n=6,068)
Do oral anticoagulants reduce recurrent ischemic stroke in patients with stroke/TIA and supracardiac atherosclerosis compared to antiplatelets?
Relative Risk: 0.91 (95% CI 0.7–1.18)
Absolute Event Rate: 2.94% vs 3.3%
In patients with stroke or TIA and supracardiac atherosclerosis, oral anticoagulants do not reduce the risk of recurrent ischemic stroke compared to antiplatelets but significantly increase the risk of major bleeding.
No takes yet. Share an insight, caveat, or question.
OACs confer no ischemic stroke prevention benefit versus antiplatelets yet raise major bleeding risk; reinforces antiplatelet preference and closes this therapeutic question.
Sagris et al. (2020) conducted a meta-analysis in stroke and supracardiac atherosclerosis (n=6,068). Oral anticoagulants vs. Antiplatelets was evaluated on Recurrent ischemic stroke (RR 0.91, 95% CI 0.70-1.18). Oral anticoagulants did not reduce recurrent ischemic stroke compared to antiplatelets (RR 0.91; 95% CI 0.70-1.18) in patients with stroke and supracardiac atherosclerosis, but increased major bleeding.
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