Combination of oral anticoagulant and antiplatelet therapy does not change the 1-year prognosis compared to oral anticoagulant alone in stroke patients with atherosclerosis and atrial fibrillation

Abstract

This study aims to evaluate the effectiveness of combined antiplatelet and oral anticoagulant (OAC) therapy versus OAC therapy alone on one-year post-stroke outcomes in patients with non-valvular atrial fibrillation (NVAF) and systemic atherosclerosis. A retrospective study was conducted using the recorded data of patients diagnosed with ischemic cerebrovascular disease between January 1, 2022, and January 1, 2023, at the Neurology Clinic, Afyonkarahisar Health Sciences University. Patients with non-valvular atrial fibrillation (NVAF) and systemic atherosclerosis were included in the study. Collected data included demographic information, medical history. Patients were divided into two groups based on the treatment regimen used at discharge: those receiving OAC alone and those receiving a combination of OAC and antiplatelet therapy. Clinical outcomes were evaluated within one year following the stroke. A total of 671 stroke patients were screened, and 565 (84.2%) had ischemic stroke. Among these, 113 (20%) had NVAF, and 53 had both NVAF and systemic atherosclerosis. Data from these 53 patients were analyzed. The mean age was 71.81±11.90 years, with a female gender ratio of 52.8%. Logistic regression analysis showed no statistically significant differences between the two treatment groups in terms of all-cause mortality, bleeding, recurrent stroke, and hemorrhagic stroke (p>0.05 for all comparisons). The combination of antiplatelet and OAC therapy did not demonstrate superiority over OAC therapy alone in reducing the risks of recurrent ischemic stroke, hemorrhagic stroke, myocardial infarction, and mortality in patients with NVAF and systemic atherosclerosis. These findings suggest that OAC therapy alone may provide sufficient protection in this patient population. Prospective studies with larger samples are needed to confirm these results.