In a nutshell
This study compared the effectiveness and safety of dabigatran etexilate (Pradaxa) and acetylsalicylic acid (Aspirin) in patients with stroke. Researchers suggested that both drugs were similar in preventing further strokes in these patients.
Some background
A stroke occurs when the supply of blood to the brain is blocked by a blood clot. When this happens, the brain does not get enough oxygen or nutrients, and brain cells start to die. 20 to 30% of strokes are of unknown cause (cryptogenic stroke, CS).
The standard treatment to prevent a second stroke after a CS are anti-platelet agents, such as aspirin. These drugs will stop platelets from sticking to each other and forming blood clots. Dabigatran etexilate (DET) has also been used to reduce the risk of a second stroke in high-risk patients. However, it is still not clear which of these two agents could be better at preventing further events in a patient with CS.
Methods & findings
The objective of this study was to compare aspirin and DET in the treatment of patients with CS.
This study included information about 5390 patients. These patients were assigned to receive DET (2695) or aspirin (2695). The average follow-up was 19 months.
Second strokes occurred in 177 patients (6.6%) in the DET group and in 207 (7.7%) in the aspirin group. Major bleeding events occurred in 77 patients (1.7% per year) in the DET group and in 64 patients (1.4% per year) in the aspirin group.
The bottom line
This study concluded that both treatments are a safe option in the prevention of a second stroke in patients with CS.
Published By :
The New England Journal of Medicine
Date :
May 16, 2019
