Why the study?
Does adding antiplatelet therapy to DOACs reduce recurrent ischemic stroke or increase major bleeding in patients with atrial fibrillation and atherosclerotic disease after ischemic stroke?
Population
Patients with atrial fibrillation and concomitant atherosclerotic disease after ischemic stroke
Comparison
Direct oral anticoagulants plus antiplatelet… vs DOAC monotherapy
Design
Meta-analysis
Key result
Adding antiplatelet therapy to DOACs did not reduce recurrent ischemic stroke (RR 0.96; 95% CI 0.80-1.14) but significantly increased major bleeding (RR 1.43; 95% CI 1.06-1.93).
Authors
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Avoid dual antithrombotic therapy in AF with atherosclerotic disease due to excess bleeding without efficacy gain; leaves open need for dedicated RCTs.
Meta-Analysis
Does adding antiplatelet therapy to DOACs reduce recurrent ischemic stroke or increase major bleeding in patients with atrial fibrillation and atherosclerotic disease after ischemic stroke?
Relative Risk: 0.96 (95% CI 0.8–1.14)
Adding antiplatelet therapy to DOACs in patients with atrial fibrillation and atherosclerotic disease after ischemic stroke does not reduce recurrent ischemic events but significantly increases the risk of major bleeding.
Bacha et al. (2026) conducted a meta-analysis in Atrial fibrillation and atherosclerotic disease after ischemic stroke. DOAC plus antiplatelet therapy vs. DOAC monotherapy was evaluated on Recurrent ischemic stroke (RR 0.96, 95% CI 0.80-1.14). Adding antiplatelet therapy to DOACs did not reduce recurrent ischemic stroke (RR 0.96; 95% CI 0.80-1.14) but significantly increased major bleeding (RR 1.43; 95% CI 1.06-1.93).