Anticoagulation and stroke . . . and other stories

The BMJ Pub Date : 2024-09-12 DOI:10.1136/bmj.q1930
British Medical Journal Publishing Group
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Abstract

Earlier this year, a large randomised controlled trial reported that early anticoagulation in people with atrial fibrillation who had sustained a stroke probably carried a small benefit over delayed anticoagulation. However, the confidence intervals around the estimated treatment effects were too wide to make definite recommendations ( N Engl J Med doi:10.1056/NEJMoa2303048). A re-analysis finds that this conclusion isn’t changed when infarct size is taken into account. The important finding is that early treatment with direct acting oral anticoagulants doesn’t carry a higher risk of bleeding complications, intracranial haemorrhage, or other adverse events, even when the infarct is large ( JAMA Neurol doi:10.1001/jamaneurol.2024.1450). Lecanemab and donanemab, both monoclonal …
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抗凝与中风......及其他故事
今年早些时候,一项大型随机对照试验报告称,对中风的心房颤动患者进行早期抗凝治疗可能比延迟抗凝治疗略有益处。然而,估计治疗效果的置信区间太大,无法提出明确的建议(N Engl J Med doi:10.1056/NEJMoa2303048)。一项重新分析发现,当考虑到梗死面积时,这一结论并没有改变。重要的发现是,早期使用直接作用口服抗凝药并不会增加出血并发症、颅内出血或其他不良事件的风险,即使梗死面积较大也是如此(JAMA Neurol doi:10.1001/jamaneurol.2024.1450)。来卡尼单抗和多那尼单抗都是单克隆抗体 ...
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