Dual versus mono antiplatelet therapy for acute non-cardioembolic ischaemic stroke or transient ischaemic attack: a systematic review and meta-analysis.

Stroke and Vascular Neurology
Yingying YangYilong Wang

Abstract

Recent years have seen new evidence on the efficacy and safety of dual antiplatelet therapy for secondary stroke prevention. We updated a meta-analysis of randomised controlled trials evaluating dual antiplatelet versus monotherapy for patients with acute non-cardioembolic ischaemic stroke (IS) or transient ischaemic attack (TIA). We searched PubMed and identified randomised controlled trials evaluating dual antiplatelet versus monotherapy for acute non-cardioembolic IS or TIA within 3 days of ictus up to May 2018. Risk ratio (RR) with 95% CI were calculated using random effects models. Clinical endpoints included stroke recurrence, composite vascular events and major bleeding. 18 randomised controlled trials including 15 515 patients were pooled in the meta-analysis. When compared with monotherapy among patients with acute IS or TIA, dual antiplatelet therapy reduced the risk of stroke recurrence (RR 0.69; 95% CI 0.61 to 0.78; p<0.001) and composite vascular events (RR 0.72; 95% CI 0.64 to 0.80; p<0.001). Dual therapy was associated with a significant increase in the risk of major bleeding (RR 1.77; 95% CI 1.09 to 2.87; p=0.02) when all trial data were combined. However, when all previous trials before the completion of the PO...Continue Reading

References

Apr 24, 1976·British Medical Journal·J T RenneyP F Burke
Sep 2, 1993·The New England Journal of Medicine·UNKNOWN GUSTO investigators
Mar 15, 2006·The New England Journal of Medicine·Deepak L BhattUNKNOWN CHARISMA Investigators
Oct 22, 2011·Journal of the Neurological Sciences·Tomomi NakamuraShinichiro Uchiyama
Nov 1, 2012·The International Journal of Neuroscience·Md Shariful HasanJohnson Stanslas
Jun 28, 2013·The New England Journal of Medicine·Yongjun WangUNKNOWN CHANCE Investigators
Jul 25, 2013·International Journal of Stroke : Official Journal of the International Stroke Society·S Claiborne JohnstonYuko Palesch
Apr 18, 2014·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Xingyang YiWanzhang Chi
Sep 13, 2014·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Fan HeHui-Sheng Chen
Dec 10, 2014·International Journal of Stroke : Official Journal of the International Stroke Society·Kazunori ToyodaUNKNOWN CSPS.com Study Investigators
Aug 28, 2015·International Journal of Stroke : Official Journal of the International Stroke Society·S Claiborne JohnstonLawrence K S Wong
May 11, 2016·The New England Journal of Medicine·S Claiborne JohnstonUNKNOWN SOCRATES Steering Committee and Investigators
Jul 16, 2016·Stroke; a Journal of Cerebral Circulation·Keun-Sik HongUNKNOWN COMPRESS Investigators
Apr 21, 2017·Neurology·Yuesong PanUNKNOWN CHANCE investigators
May 17, 2018·The New England Journal of Medicine·S Claiborne JohnstonUNKNOWN Clinical Research Collaboration, Neurological Emergencies Treatment Trials Network, and the POINT Investigators

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Citations

Mar 12, 2019·Stroke; a Journal of Cerebral Circulation·Hammad RahmanEdo Kaluski
Mar 2, 2019·BMJ : British Medical Journal·Yongjun WangHao Li
Feb 14, 2020·European Journal of Neurology : the Official Journal of the European Federation of Neurological Societies·Y YangY Wang
Mar 3, 2020·Frontiers in Neurology·Franziska LieschkeChristian Foerch
Oct 14, 2020·Expert Review of Neurotherapeutics·Ka Hou Christien LiGregory Y H Lip

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Methods Mentioned

BETA
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Clinical Trials Mentioned

NCT03354429
NCT01995370

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