European journal of internal medicine
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Eur. J. Intern. Med. · Jan 2022
Meta AnalysisOral anticoagulants vs antiplatelets in cryptogenic stroke with potential cardiac emboli: Meta-analysis.
The best antithrombotic strategy for cryptogenic stroke with potential cardiac emboli is not known. The objective of this study was to conduct a meta-analysis to evaluate the efficacy and safety of oral anticoagulants (OACs) vs. antiplatelet therapies in these patients METHODS: Pubmed, EMBASE, CENTRAL and clinicaltrials.gov were searched from January 1980 to April 2021 to identify trials comparing OACs versus antiplatelet therapies in patients with cryptogenic stroke and potential cardiac emboli (patent foramen ovale, moderate-severe left atrial enlargement, heart failure with reduced ejection fraction). Relative risk (RR) with 95% confidence (CI) was used as a measure of the effect of OACs versus antiplatelet therapies on recurrent ischemic stroke and major bleeding. We computed a random-effect estimate based on the Mantel-Haenszel method for a given outcome. ⋯ OACs compared with antiplatelet therapies were associated with a reduced recurrent ischemic stroke risk and OACs might be a viable non-procedural alternative in patients with cryptogenic stroke and potential cardiac emboli.
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Eur. J. Intern. Med. · Jan 2022
Meta AnalysisExtended venous thromboprophylaxis in patients hospitalized for acute ischemic stroke: A systematic review and meta-analysis.
Patients hospitalized for acute ischemic stroke have an increased risk of venous thromboembolism (VTE) that may persist beyond the currently recommended period of 6 to 14 days of thromboprophylaxis. This systematic review evaluated the efficacy and safety of extended venous thromboprophylaxis in patients hospitalized for acute ischemic stroke. ⋯ In patients hospitalized for acute ischemic stroke, the net clinical benefit may favor extended venous thromboprophylaxis for four to five weeks over standard thromboprophylaxis.