Optimal Antithrombotics for Ischemic Stroke and Concurrent Atrial Fibrillation and Atherosclerosis

What are the risks and benefits of adding an antiplatelet agent to anticoagulant therapy in patients with ischemic stroke and concurrent atrial fibrillation and atherosclerosis?In this randomized clinical trial of 316 patients, there was no significant difference in the composite outcome of ischemic events and major bleeding between combination therapy and monotherapy groups. However, combination therapy was associated with a higher incidence of major and clinically relevant nonmajor bleeding.Adding an antiplatelet agent to anticoagulants did not provide overall clinical benefit and increased bleeding risk, suggesting that anticoagulant monotherapy may be a safer option in this high-risk population.

Corresponding Author: Hiroshi Yamagami, MD, PhD, Division of Stroke Prevention and Treatment, Institute of Medicine, University of Tsukuba, 1-1-1 Tennodai, Tsukuba 305-8575, Japan (yamagami.brain@outlook.com).

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