ArticleFrontiers in neurology2026
Single vs. dual antiplatelet therapy before DOAC initiation in acute ischemic stroke with atrial fibrillation: a retrospective cohort study.
Article in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The optimal antiplatelet bridging strategy before initiating direct oral anticoagulants (DOACs) in patients with acute ischemic stroke (AIS) and non-valvular atrial fibrillation (NVAF) remains uncertain. Methods: This single-center retrospective cohort study included 120 patients with AIS and NVAF who received antiplatelet therapy prior to DOAC initiation. Patients were stratified by regimen: single antiplatelet therapy (SAPT, Results: Baseline characteristics were comparable between groups, with no significant differences in baseline NIHSS score (median 4.00 vs. 2.00, Conclusion: In unadjusted analysis, DAPT prior to DOAC initiation was associated with higher 90-day favorable functional outcome without excess bleeding risk. However, this association was not independent of baseline stroke severity after multivariable adjustment, suggesting that the crude benefit was largely attributable to selection bias rather than a true therapeutic advantage of DAPT. The current data do not support the superiority of DAPT over SAPT. Baseline NIHSS score independently predicted both short-term and long-term outcomes. These hypothesis-generating findings warrant confirmation in adequately powered prospective randomized trials.
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