Meta-analysis
Outcomes of patients with atrial fibrillation and ischemic stroke while on oral anticoagulation
- Pooled individual participant data analysis of five randomised trials
Authors' conclusion
Patients with AF and ischemic stroke while on oral anticoagulation are at increased risk of recurrent ischemic stroke and death.
Study context
- Population
- Patients with atrial fibrillation (AF) and a first post-randomisation ischemic stroke while on study medication (warfarin, standard- or lower-dose DOAC) in five pivotal antithrombotic trials
- Participants
- 1,163 patients
- Outcome
- Recurrent ischemic stroke after the first post-randomization ischemic stroke
Pooled result
As reported in the abstract
Recurrent ischemic stroke · 1 year
Patients with recurrent ischemic stroke (median follow-up 337 days)
74
Cumulative incidence at 1 year
7.0% (95% CI 5.2%-8.7%)
Further pooled results
Mortality · 3 months after stroke
- Cumulative incidence
- 12.4% (95% CI 10.5%-14.4%)
Recurrent ischemic stroke at 1 year, accounting for competing risk of death
- Cumulative incidence
- 6.2% (95% CI 4.8%-7.9%)
Recurrent ischemic stroke at 1 year, landmark analysis (excluding first 2 weeks; no permanent study drug discontinuation)
- Cumulative incidence
- 6.8% (95% CI 4.6%-8.9%)
Original publication
Outcomes of patients with atrial fibrillation and ischemic stroke while on oral anticoagulation. Eur Heart J. Published 11 April 2023. doi:10.1093/eurheartj/ehad200
Summarised from the published abstract; every number is checked against it