Comparative efficacy and safety of dual antiplatelet therapy strategies defined by drug composition and treatment duration for acute minor ischemic stroke or high-risk transient ischemic attack: A systematic review and Bayesian network meta-analysis.
Sixuan Zou, Ruoxuan Liu, Shuman Zhang et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review and Bayesian network meta-analysis evaluated dual antiplatelet therapy (DAPT) strategies for acute minor ischemic stroke or high-risk transient ischemic attack in 50,349 patients. Ticagrelor plus aspirin for 21 days significantly reduced recurrent ischemic stroke compared to aspirin monotherapy (OR 0.55, 95% CrI 0.46-0.66), while clopidogrel plus aspirin for 21 days showed the best overall benefit-risk profile.
Key findings
- Ticagrelor plus aspirin for 21 days reduced recurrent ischemic stroke compared to aspirin monotherapy (OR 0.55, 95% CrI 0.46-0.66).
- Clopidogrel plus aspirin for 21 days had no significant increase in major bleeding risk (OR 1.05, 95% CrI 0.70-1.58).
- Ticagrelor plus aspirin for 30 days had the highest bleeding hazard (OR 2.10, 95% CrI 1.50-2.94).
- Clopidogrel plus aspirin for 21 days provided the most favorable net clinical benefit.
Why it matters
Understanding the comparative efficacy and safety of DAPT strategies is crucial for optimizing secondary prevention in patients with acute minor ischemic stroke or high-risk TIA, allowing for tailored treatment approaches based on individual risk profiles.