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Antithrombotic treatment in patients with stroke and supracardiac atherosclerosis

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Antithrombotic treatment in patients with stroke and supracardiac atherosclerosis. / Sagris, Dimitrios; Georgiopoulos, Georgios; Leventis, Ioannis; Pateras, Konstantinos; Pearce, Lesly A.; Korompoki, Eleni; Makaritsis, Konstantinos; Vemmos, Konstantinos; Milionis, Haralampos; Ntaios, George.

In: Neurology, Vol. 95, No. 5, 04.08.2020, p. e499-e507.

Research output: Contribution to journalArticle

Harvard

Sagris, D, Georgiopoulos, G, Leventis, I, Pateras, K, Pearce, LA, Korompoki, E, Makaritsis, K, Vemmos, K, Milionis, H & Ntaios, G 2020, 'Antithrombotic treatment in patients with stroke and supracardiac atherosclerosis', Neurology, vol. 95, no. 5, pp. e499-e507. https://doi.org/10.1212/WNL.0000000000009823

APA

Sagris, D., Georgiopoulos, G., Leventis, I., Pateras, K., Pearce, L. A., Korompoki, E., Makaritsis, K., Vemmos, K., Milionis, H., & Ntaios, G. (2020). Antithrombotic treatment in patients with stroke and supracardiac atherosclerosis. Neurology, 95(5), e499-e507. https://doi.org/10.1212/WNL.0000000000009823

Vancouver

Sagris D, Georgiopoulos G, Leventis I, Pateras K, Pearce LA, Korompoki E et al. Antithrombotic treatment in patients with stroke and supracardiac atherosclerosis. Neurology. 2020 Aug 4;95(5):e499-e507. https://doi.org/10.1212/WNL.0000000000009823

Author

Sagris, Dimitrios ; Georgiopoulos, Georgios ; Leventis, Ioannis ; Pateras, Konstantinos ; Pearce, Lesly A. ; Korompoki, Eleni ; Makaritsis, Konstantinos ; Vemmos, Konstantinos ; Milionis, Haralampos ; Ntaios, George. / Antithrombotic treatment in patients with stroke and supracardiac atherosclerosis. In: Neurology. 2020 ; Vol. 95, No. 5. pp. e499-e507.

Bibtex Download

@article{b039bd0dd82040a0b0b9e62b76b98242,
title = "Antithrombotic treatment in patients with stroke and supracardiac atherosclerosis",
abstract = "OBJECTIVE: To compare the efficacy and safety of oral anticoagulants vs antiplatelets in patients with stroke and atherosclerotic plaques in the aortic arch or cervical or intracranial arteries, collectively described as supracardiac atherosclerosis. METHODS: We searched PubMed and Scopus until August 28, 2019, for randomized trials comparing oral anticoagulants vs antiplatelets in patients with stroke and supracardiac atherosclerosis using the terms {"}anticoagulant or anticoagulation{"} and {"}antiplatelet or aspirin{"} and {"}randomized controlled trial or RCT{"} and {"}stroke or cerebral ischemia{"} and {"}aortic or carotid or vertebrobasilar or intracranial or atherosclerosis or stenosis or arterial.{"} Four outcomes were assessed: recurrent ischemic stroke, major ischemic event or death, major bleeding, and intracranial bleeding. Treatment effects (relative risk [RR] and 95% confidence interval [CI]) were estimated by meta-analysis using random-effects models. RESULTS: Among 1,117 articles identified in the literature search, results from 10 randomized controlled trials involving 6,068 patients with stroke/TIA with supracardiac atherosclerosis were included in the meta-analysis. Recurrent ischemic stroke rates were 2.94 per 100 patient-years in the anticoagulant-assigned patients vs 3.30 per 100 patient-years in the antiplatelet-assigned patients (RR, 0.91; 95% CI, 0.70-1.18 for the SJ estimator, I2 = 26%). Major ischemic event or death rates were 4.39 per 100 patient-years in anticoagulant-assigned patients vs 4.32 in antiplatelet-assigned patients (RR, 1.03; 95% CI, 0.79-1.35; I2 = 54.5%). Major bleeding rates were 2.88 per 100 patient-years in anticoagulant-assigned patients vs 0.82 in antiplatelet-assigned patients (RR, 3.21; 95% CI, 1.96-5.24; I2 = 46%). CONCLUSION: This systematic review and meta-analysis showed that anticoagulant-assigned patients with stroke and supracardiac atherosclerosis were not at different risk of ischemic stroke recurrence and increased risk of major bleeding compared to antiplatelet-assigned patients.",
author = "Dimitrios Sagris and Georgios Georgiopoulos and Ioannis Leventis and Konstantinos Pateras and Pearce, {Lesly A.} and Eleni Korompoki and Konstantinos Makaritsis and Konstantinos Vemmos and Haralampos Milionis and George Ntaios",
year = "2020",
month = aug,
day = "4",
doi = "10.1212/WNL.0000000000009823",
language = "English",
volume = "95",
pages = "e499--e507",
journal = "Neurology",
issn = "0028-3878",
number = "5",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - Antithrombotic treatment in patients with stroke and supracardiac atherosclerosis

AU - Sagris, Dimitrios

AU - Georgiopoulos, Georgios

AU - Leventis, Ioannis

AU - Pateras, Konstantinos

AU - Pearce, Lesly A.

AU - Korompoki, Eleni

AU - Makaritsis, Konstantinos

AU - Vemmos, Konstantinos

AU - Milionis, Haralampos

AU - Ntaios, George

PY - 2020/8/4

Y1 - 2020/8/4

N2 - OBJECTIVE: To compare the efficacy and safety of oral anticoagulants vs antiplatelets in patients with stroke and atherosclerotic plaques in the aortic arch or cervical or intracranial arteries, collectively described as supracardiac atherosclerosis. METHODS: We searched PubMed and Scopus until August 28, 2019, for randomized trials comparing oral anticoagulants vs antiplatelets in patients with stroke and supracardiac atherosclerosis using the terms "anticoagulant or anticoagulation" and "antiplatelet or aspirin" and "randomized controlled trial or RCT" and "stroke or cerebral ischemia" and "aortic or carotid or vertebrobasilar or intracranial or atherosclerosis or stenosis or arterial." Four outcomes were assessed: recurrent ischemic stroke, major ischemic event or death, major bleeding, and intracranial bleeding. Treatment effects (relative risk [RR] and 95% confidence interval [CI]) were estimated by meta-analysis using random-effects models. RESULTS: Among 1,117 articles identified in the literature search, results from 10 randomized controlled trials involving 6,068 patients with stroke/TIA with supracardiac atherosclerosis were included in the meta-analysis. Recurrent ischemic stroke rates were 2.94 per 100 patient-years in the anticoagulant-assigned patients vs 3.30 per 100 patient-years in the antiplatelet-assigned patients (RR, 0.91; 95% CI, 0.70-1.18 for the SJ estimator, I2 = 26%). Major ischemic event or death rates were 4.39 per 100 patient-years in anticoagulant-assigned patients vs 4.32 in antiplatelet-assigned patients (RR, 1.03; 95% CI, 0.79-1.35; I2 = 54.5%). Major bleeding rates were 2.88 per 100 patient-years in anticoagulant-assigned patients vs 0.82 in antiplatelet-assigned patients (RR, 3.21; 95% CI, 1.96-5.24; I2 = 46%). CONCLUSION: This systematic review and meta-analysis showed that anticoagulant-assigned patients with stroke and supracardiac atherosclerosis were not at different risk of ischemic stroke recurrence and increased risk of major bleeding compared to antiplatelet-assigned patients.

AB - OBJECTIVE: To compare the efficacy and safety of oral anticoagulants vs antiplatelets in patients with stroke and atherosclerotic plaques in the aortic arch or cervical or intracranial arteries, collectively described as supracardiac atherosclerosis. METHODS: We searched PubMed and Scopus until August 28, 2019, for randomized trials comparing oral anticoagulants vs antiplatelets in patients with stroke and supracardiac atherosclerosis using the terms "anticoagulant or anticoagulation" and "antiplatelet or aspirin" and "randomized controlled trial or RCT" and "stroke or cerebral ischemia" and "aortic or carotid or vertebrobasilar or intracranial or atherosclerosis or stenosis or arterial." Four outcomes were assessed: recurrent ischemic stroke, major ischemic event or death, major bleeding, and intracranial bleeding. Treatment effects (relative risk [RR] and 95% confidence interval [CI]) were estimated by meta-analysis using random-effects models. RESULTS: Among 1,117 articles identified in the literature search, results from 10 randomized controlled trials involving 6,068 patients with stroke/TIA with supracardiac atherosclerosis were included in the meta-analysis. Recurrent ischemic stroke rates were 2.94 per 100 patient-years in the anticoagulant-assigned patients vs 3.30 per 100 patient-years in the antiplatelet-assigned patients (RR, 0.91; 95% CI, 0.70-1.18 for the SJ estimator, I2 = 26%). Major ischemic event or death rates were 4.39 per 100 patient-years in anticoagulant-assigned patients vs 4.32 in antiplatelet-assigned patients (RR, 1.03; 95% CI, 0.79-1.35; I2 = 54.5%). Major bleeding rates were 2.88 per 100 patient-years in anticoagulant-assigned patients vs 0.82 in antiplatelet-assigned patients (RR, 3.21; 95% CI, 1.96-5.24; I2 = 46%). CONCLUSION: This systematic review and meta-analysis showed that anticoagulant-assigned patients with stroke and supracardiac atherosclerosis were not at different risk of ischemic stroke recurrence and increased risk of major bleeding compared to antiplatelet-assigned patients.

UR - http://www.scopus.com/inward/record.url?scp=85089129073&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000009823

DO - 10.1212/WNL.0000000000009823

M3 - Article

C2 - 32631920

AN - SCOPUS:85089129073

VL - 95

SP - e499-e507

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 5

ER -

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