For any therapeutic intervention, benefits should be balanced against risks. With antithrombotics for prevention of stroke in patients with a history of stroke or transient ischaemic attack, treatment-related reductions in recurrent ischaemic events need to be weighed against the risk of bleeding complications. A meta-analysis has indicated that use of aspirin-the gold standard for comparison of novel antithrombotics for secondary stroke prevention-leads to a 17% reduction in major vascular events (rate ratio [RR] 0-83, 95% Cl 0-75-0-93, p=0001) with a 17% reduction in all strokes (0-83, 0-72-0-96, p=0-01), including a 21% reduction in definite ischaemic stroke (0-78, 0-62-1-00, p=005). Risk of brain haemorrhage is increased (1-90, 1-06-3-44, p=003) as are rates of extracranial, predominately gastrointestinal, bleeding events (2-69,1-25-5-76, p=0-01).
展开▼
