SynthesisThe Cochrane database of systematic reviews2000
Anticoagulants versus antiplatelet therapy for preventing stroke in patients with nonrheumatic atrial fibrillation and a history of stroke or transient ischemic attacks.
Synthesis in The Cochrane database of systematic reviews, 2000. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed, 9 citations in OpenAlex.
- The use of antithrombotics in patients presenting with stroke and atrial fibrillation.Therapeutics and clinical risk management · 2007Article
- Long term anticoagulation or antiplatelet treatment. Only warfarin has been shown to reduce stroke risk in patients with atrial fibrillation.BMJ (Clinical research ed.) · 2001Article
- Characteristics of patients with cryptogenic stroke and atrial fibrillation detected using insertable cardiac monitoring in the chronic phase: a subanalysis of the LOOK study.Frontiers in neurologyArticle
Corrections and comments
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Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPeople with nonrheumatic atrial fibrillation who have had a transient ischemic attack or minor ischemic stroke are at risk of recurrent stroke.
objectivesThe objective of this review was to compare the effect of anticoagulants with antiplatelet therapy, for secondary prevention, in people with nonrheumatic atrial fibrillation and previous cerebral ischaemia. SEARCH STRATEGY: The reviewer searched the Cochrane Stroke Group trials register and contacted trialists. SELECTION CRITERIA: Randomised trials comparing oral anticoagulants with aspirin in patients with non-rheumatic atrial fibrillation and a previous transient ischaemic attack or minor ischaemic stroke. DATA COLLECTION AND ANALYSIS: One reviewer extracted the data. MAIN
resultsOne trial was included, involving 455 patients. They received either anticoagulants (International Normalised Ratio 2.5 to 4.0), or 300 milligrams of aspirin per day. People joined the trial within three months of transient ischaemic attack or minor stroke. The mean follow-up was 2.3 years. Anticoagulant therapy approximately halved the odds of serious vascular events (odds ratio 0.55, 95% confidence interval 0.36 to 0. 83). This equates to preventing an extra 50 vascular events per year for every 1000 patients treated. Anticoagulant therapy decreased the odds of recurrent stroke by two-thirds (odds ratio 0.35, 95% confidence interval 0.22 to 0.59). This translates to preventing an extra 60 strokes for every 1000 patients treated per year. Major extracranial bleeds occurred more often in patients given anticoagulants (odds ratio 4.65, 95% confidence interval 1.66 to 12.99). The absolute difference was 2.8% versus 0.9% bleeds per year. None of the patients on anticoagulants and one on aspirin had an intracerebral bleed. REVIEWER'S
conclusionsThe evidence from one trial suggests that anticoagulant therapy can benefit people with nonrheumatic atrial fibrillation and recent cerebral ischaemia. Aspirin may be a useful alternative if there is a contraindication to anticoagulant therapy. The risk of adverse events appears to be higher with anticoagulant therapy than aspirin.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.