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(Stroke. 2005;36:914.)
© 2005 American Heart Association, Inc.

Cochrane Corner

Anticoagulants Versus Antiplatelet Therapy for Preventing Stroke in Patients With Nonrheumatic Atrial Fibrillation and a History of Stroke or Transient Ischemic Attack

From the Department of Neurology (R.S.), Medical Center Rijnmond-Zuid, Rotterdam; and the Department of Neurology (P.J.K.), Erasmus Medical Center, University Hospital Rotterdam, The Netherlands.

Correspondence to Ritu Saxena, MD, PhD, Department of Neurology, Medical Center Rijnmond-Zuid, Olympiaweg 350, 3078 HT Rotterdam, The Netherlands. E-mail saxenar@mcrz.nl

Section Editor: Graeme J. Hankey MD, FRACP

Key Words: anticoagulants • atrial fibrillation • platelet aggregation inhibitors • stroke prevention

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
People with nonrheumatic atrial fibrillation (NRAF) who have had a transient ischemic attack (TIA) or a minor ischemic stroke are at high-risk of recurrent stroke. Both warfarin and aspirin have been shown to reduce the recurrence of vascular events.

	Objectives

 
The objective of this review was to compare the effect of anticoagulants with antiplatelet agents, for secondary prevention, after a stroke or TIA, in patients with NRAF.

	Search Strategy

 
This review has drawn on the search strategy developed for the Stroke Group as a whole. Relevant trials were identified in the Stroke Group Trials Register (last search June 9, 2003). We also contacted researchers in the field to identify further published and unpublished studies.

	Selection Criteria

 
Randomized trials comparing oral anticoagulants with antiplatelet agents in patients with NRAF and a previous TIA or minor ischemic stroke.

	Data Collection and Analysis

 
Both reviewers assessed trial quality and extracted data. The main outcomes considered were (1) fatal or nonfatal recurrent stroke; (2) all major vascular events: vascular death (including fatal bleeds), recurrent stroke (both ischemic and hemorrhagic), myocardial infarction, and systemic embolism; (3) any intracranial bleed; (4) major extracranial bleed.

	Results

 
Two trials were identified. In the European Atrial Fibrillation Trial (EAFT) 455 patients received either anticoagulants (International Normalized Ratio [INR] 2.5 to 4.0), or aspirin (300 mg/d). Patients joined the trial within three months of transient ischemic attack or minor stroke. The mean follow up was 2.3 years. In the Studio Italiano Fibrillazione Atriale (SIFA) trial, 916 patients with NRAF and a TIA or minor stroke within the previous 15 days . . . [Full Text of this Article]