Evangelos Panagiotopoulos: Apixaban Reduces Stroke and Major Bleeding Risk in Secondary Stroke Prevention
Evangelos Panagiotopoulos, Neurology Resident at General Hospital of Athens “Korgialenio-Benakeio”, shared a post on LinkedIn about a recent article he and his colleague co-authored, published in Stroke, adding:
“Excited to share that our systematic review and network meta-analysis, entitled ‘Comparative Safety and Efficacy of Oral Anticoagulants in Patients With Atrial Fibrillation and Prior Ischemic Stroke,’ has just been published in Stroke.
We evaluated the comparative efficacy and safety of oral anticoagulants for secondary stroke prevention in patients with atrial fibrillation and a history of ischemic stroke or TIA.
Our analysis included 6 randomized controlled trials involving 18,395 patients.
Key findings:
- Apixaban was the only DOAC associated with significant reductions in both stroke and major bleeding compared with warfarin.
- Dabigatran, apixaban, and edoxaban significantly reduced hemorrhagic stroke and intracranial hemorrhage compared with warfarin.
- Edoxaban was associated with significantly lower cardiovascular and all-cause mortality compared with warfarin.
- Importantly, no significant differences between individual DOACs were established, with all head-to-head comparisons relying on indirect evidence.
These findings provide further insights into anticoagulant selection for secondary stroke prevention, while highlighting the need for direct comparative randomized trials in this high-risk population.
Grateful to all co-authors and collaborators for their valuable contributions to this international research effort!”
Title: Comparative Safety and Efficacy of Oral Anticoagulants in Patients With Atrial Fibrillation and Prior Ischemic Stroke: A Systematic Review and Network Meta-Analysis of Randomized-Controlled Clinical Trials
Authors: Nikolaos M Papageorgiou, Lina Palaiodimou, Aikaterini Theodorou, Maria-Ioanna Stefanou, Evangelos Panagiotopoulos, Aristeidis H Katsanos, Apostolos Safouris, Odysseas Kargiotis, Simona Sacco, Guillaume Turc, Urs Fischer, Pooja Khatri, Shadi Yaghi, Georgios Tsivgoulis
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