Bartosz Hudzik: New Evidence on “Aspirin Failure” After Ischemic Stroke
Bartosz Hudzik, Editorial Consultant at JACC Case Reports, shared on LinkedIn:
”New evidence on “aspirin failure” after ischemic stroke
Patients who suffer an ischemic stroke while already taking aspirin represent a high-risk and frustrating clinical group.
The common reflex is to switch antithrombotic therapy—but does it actually help?
A new systematic review and network meta-analysis of 9 randomized trials (5,459 patients, median follow-up ~19 months) found:
- Switching to another antithrombotic (DOAC, DAPT, or warfarin) did not significantly reduce recurrent ischemic stroke compared with continuing aspirin
- No significant benefit was seen for the composite outcome of stroke, MI, or death
- DOACs (dabigatran, apixaban) and aspirin plus low-dose rivaroxaban ranked highest in network analyses—but none were superior to aspirin
Bottom line: After an ischemic stroke on aspirin, simply switching antithrombotic therapy may not meaningfully improve outcomes.
This highlights a major unmet need—and the importance of trials designed specifically for this growing population.
Read the full article here.”
Article: Switching From Aspirin Monotherapy After Noncardioembolic Stroke: A Systematic Review and Network Meta-Analysis
Authors: Aaron Rothstein, Ossama Khazaal, Steven Messe, Yulun Liu, Sean Hennessy, Yong Chen, Ale Algra, Shinichiro Uchiyama, Sven Poli, Tobias Geisler, Lina Maria Serna Higuita, Kanjana Perera, Amanda Taylor, Scott E. Kasner
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