SynthesisStroke2026
Switching From Aspirin Monotherapy After Noncardioembolic Stroke: A Systematic Review and Network Meta-Analysis.
Synthesis in Stroke, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
- Migraine as a risk factor for retinal vascular events and maculopathies: a systematic review and meta-analysis of 47 million individuals.The journal of headache and pain · 2026Pooled it
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
backgroundPatients who experience an ischemic stroke while on aspirin therapy present a clinical dilemma about optimal long-term secondary prevention. While switching to an alternative antithrombotic agent is often considered, the effectiveness of switching remains uncertain.
methodsWe conducted a systematic review and network meta-analysis of randomized controlled trials reporting outcomes among patients with ischemic stroke while on aspirin who were either continued on aspirin or switched to an alternative antithrombotic therapy. Alternative antithrombotics included 2 trials of vitamin K antagonists (n=478), 3 trials of dual antiplatelet therapy (n=2229), 3 trials of direct oral anticoagulant (n=2660) monotherapy, and 1 trial of low-dose direct oral anticoagulant added onto aspirin (n=92). We excluded trials of patients with only short-term outcomes of 90 days or fewer, or those with cardioembolic sources of stroke requiring anticoagulation. Our primary outcome was recurrent ischemic stroke; the secondary outcome was a composite of ischemic stroke, myocardial infarction, and vascular death (or all-cause mortality). Outcomes reflect recurrent events measured over a median of ≈19 months (range 11-42 months). In the network portion of this meta-analysis, surface under the cumulative ranking curve rankings and pairwise meta-analyses were used to evaluate and compare the relative efficacy of alternative antithrombotic medications.
resultsData were available from 9 studies (total N=5459 patients) for the outcome of recurrent ischemic stroke. Switching to another therapy was associated with a pooled relative risk of recurrent stroke of 0.88 (95% CI, 0.76-1.03) compared with continuing aspirin, with minimal heterogeneity (
conclusionsAmong patients experiencing ischemic stroke while taking aspirin, switching to an alternative antithrombotic therapy was not conclusively associated with a reduction in recurrent stroke and composite cardiovascular events. Trials are needed to determine whether specific antithrombotic strategies meaningfully improve outcomes in this high-risk population.
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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.