| mechanism | treatment | Demonstrated benefit and harm | k | | | |
|---|
| anti hypertensive agents | telmisartan | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| T1 vs T0 | | | |
| Trial | Treatments | Patients | Method |
|---|
| PROFESS, 2008 | telmisartan 80 mg/d (n=-9) vs. placebo (n=-9) | | Sample size: -9/-9 Primary endpoint: FU duration: |
|
| anticoagulant | dicoumarol | versus No demonstrated result for efficacy dicoumarol inferior to placebo in terms of Major extracranial haemorrhage in Nat-Coop, 1962 | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| Howard, 1963 | dicoumarol vs placebo | | | Deaths from any cause 1.00 [0.24; 4.18] Vascular deaths 1.00 [0.24; 4.18] Symptomatic intracranial haemorrhage NaN [NaN; NaN] Major extracranial haemorrhage NaN [NaN; NaN] | | Nat-Coop, 1962 | dicoumarol vs placebo | Non-fatal stroke/intracranial haemorrhage or vascular death 0.73 [0.54; 1.00] | Major extracranial haemorrhage 10.51 [2.50; 44.16] | Recurrent ischaemic/unknown stroke 0.56 [0.26; 1.20] Symptomatic intracranial haemorrhage 2.23 [0.58; 8.51] Any recurrent stroke or symptomatic intracranial haemorrhage 0.63 [0.36; 1.08] Myocardial infarction 0.76 [0.31; 1.90] |
| Trial | Treatments | Patients | Method |
|---|
| Howard, 1963 | dicumarol, TP 15 to 25% of normal (n=-9) vs. placebo (n=-9) | | single-blind Parallel groups Sample size: -9/-9 Primary endpoint: FU duration: 1 year | | Nat-Coop, 1962 | heparin 50 mg 4-hourly iv then dicumarol, Quick test 15% to 25% of control (n=-9) vs. placebo (n=-9) | | single-blind Parallel groups Sample size: -9/-9 Primary endpoint: FU duration: 13 months |
|
| anticoagulant | phenindione | versus No demonstrated result for efficacy | 2 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| Enger, 1965 | phenindione vs placebo | | | Death or dependency 1.11 [0.92; 1.34] Non-fatal stroke, myocardial infarction or vascular death 0.70 [0.48; 1.04] Deaths from any cause 1.12 [0.65; 1.90] Vascular deaths 0.91 [0.50; 1.65] Recurrent ischaemic/unknown stroke 0.51 [0.24; 1.07] Symptomatic intracranial haemorrhage 2.55 [0.27; 23.77] Any recurrent stroke or symptomatic intracranial haemorrhage 0.64 [0.33; 1.22] Major extracranial haemorrhage ∞ [NaN; ∞] Myocardial infarction 1.06 [0.30; 3.75] Other embolic events 0.85 [0.05; 13.25] Non-fatal stroke/intracranial haemorrhage or vascular death 0.72 [0.48; 1.09] | | Thygesen, 1964 | phenindione vs placebo | | | Deaths from any cause 1.41 [0.34; 5.85] Vascular deaths 2.12 [0.42; 10.82] Recurrent ischaemic/unknown stroke 1.48 [0.52; 4.22] Symptomatic intracranial haemorrhage ∞ [NaN; ∞] Any recurrent stroke or symptomatic intracranial haemorrhage 1.91 [0.71; 5.11] Myocardial infarction 0.00 [0.00; NaN] Non-fatal stroke/intracranial haemorrhage or vascular death 1.52 [0.65; 3.51] |
| Trial | Treatments | Patients | Method |
|---|
| Enger, 1965 | phenindione thrombotest 10% to 25% of normal, started in hospital (n=-9) vs. placebo (n=-9) | | single-blind Parallel groups Sample size: -9/-9 Primary endpoint: FU duration: 22.7 months | | Thygesen, 1964 | phenindione, prothrombin-proconvertin test 10% to 20% (n=-9) vs. placebo (n=-9) | | single-blind Parallel groups Sample size: -9/-9 Primary endpoint: FU duration: 29.5 months |
|
| anticoagulant | rivaroxaban | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| NAVIGATE ESUS, 2018 | rivaroxaban vs aspirin | | | |
| Trial | Treatments | Patients | Method |
|---|
| NAVIGATE ESUS, 2018 | rivaroxaban (at a daily dose of 15 mg) (n=3609) vs. aspirin (at a daily dose of 100 mg) (n=3604) | patients with recent ischemic stroke that was presumed to be from cerebral embolism but without arterial stenosis, lacune, or an identified cardioembolic source | Sample size: 3609/3604 Primary endpoint: first recurrence of ischemic or hemorrhagic stroke or systemic embolism FU duration: |
|
| anticoagulant | warfarin | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| SWAT, 1998 | warfarin vs aspirin | | | Deaths from any cause 1.43 [0.25; 8.23] Recurrent ischaemic/unknown stroke 0.63 [0.11; 3.66] Any recurrent stroke or symptomatic intracranial haemorrhage 0.63 [0.11; 3.66] Major extracranial haemorrhage 1.27 [0.47; 3.43] Myocardial infarction 2.85 [0.31; 26.65] Non-fatal stroke/intracranial haemorrhage or vascular death 0.95 [0.29; 3.11] |
| Trial | Treatments | Patients | Method |
|---|
| SWAT, 1998 | warfarin (INR 2.0 to 3.0) (n=-9) vs. Enteric-coated aspirin 650 mg 12-hourly (n=-9) 3 arms: Enteric-coated aspirin 650 mg 12-hourly; warfarin (INR 2.0 to 3.0) and warfarin plus aspirin 80
mg 24-hourly | | open Parallel groups Sample size: -9/-9 Primary endpoint: FU duration: 2 years |
|
| antiplatelets drug | aspirin | versus placebo or control No demonstrated result for efficacy | 12 trials | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| Canadian study (CCSG), 1978 | aspirin vs placebo | | | Non fatal stroke 1.09 [0.57; 2.10] Major CV events 1.06 [0.69; 1.64] All deaths 0.79 [0.41; 1.55] CV deaths 0.71 [0.34; 1.49] | | Swedish study , 1987 | aspirin vs placebo | | | Non fatal stroke 1.22 [0.67; 2.21] Fatal stroke 0.80 [0.32; 1.99] Non fatal MI 1.10 [0.47; 2.53] Major CV events 1.07 [0.77; 1.48] All deaths 0.92 [0.59; 1.41] CV deaths 0.96 [0.59; 1.57] Stroke 1.22 [0.67; 2.21] | | UK-TIA low dose , 1988 | aspirin vs placebo | | | Non fatal stroke 0.77 [0.56; 1.05] Fatal stroke 1.07 [0.56; 2.06] Non fatal MI 0.74 [0.45; 1.23] Major CV events 0.91 [0.76; 1.09] All deaths 0.90 [0.71; 1.15] CV deaths 1.07 [0.81; 1.41] Stroke 0.77 [0.56; 1.05] | | UK-TIA high dose , 1988 | aspirin vs placebo | Non fatal MI 0.50 [0.28; 0.89] | | Non fatal stroke 0.76 [0.55; 1.04] Fatal stroke 1.18 [0.62; 2.23] Major CV events 0.87 [0.72; 1.04] All deaths 0.92 [0.72; 1.16] CV deaths 1.03 [0.78; 1.37] Stroke 0.76 [0.55; 1.04] | | SALT , 1991 | aspirin vs placebo | | | Non fatal stroke 0.76 [0.58; 1.01] Fatal stroke 1.62 [0.74; 3.54] Non fatal MI 0.91 [0.59; 1.41] Major CV events 0.85 [0.71; 1.02] All deaths 0.89 [0.64; 1.24] CV deaths 0.99 [0.68; 1.44] Stroke 0.76 [0.58; 1.01] | | Reuther , 1976 | aspirin vs placebo | | | Non fatal stroke 1.00 [0.15; 6.64] Non fatal MI NaN [NaN; NaN] Major CV events 0.40 [0.08; 1.90] All deaths 0.00 [0.00; NaN] CV deaths 0.00 [0.00; NaN] Stroke 1.00 [0.15; 6.64] | | AITA, 1975 | aspirin vs placebo | | | Non fatal stroke 0.58 [0.29; 1.15] Fatal stroke 0.24 [0.03; 2.14] Non fatal MI 1.94 [0.36; 10.43] Major CV events 0.72 [0.46; 1.14] All deaths 0.61 [0.28; 1.29] CV deaths 0.75 [0.34; 1.65] Stroke 0.58 [0.29; 1.15] | | DCS, 1980 | aspirin vs placebo | | | Non fatal stroke 1.18 [0.57; 2.42] Fatal stroke 3.03 [0.32; 28.64] Non fatal MI 0.25 [0.05; 1.16] Major CV events 0.86 [0.53; 1.39] All deaths 1.11 [0.49; 2.50] CV deaths 1.01 [0.39; 2.59] Stroke 1.18 [0.57; 2.42] | | AICLA, 1981 | aspirin vs placebo | | | Non fatal stroke 0.66 [0.36; 1.20] Fatal stroke 0.52 [0.05; 5.64] Non fatal MI 0.15 [0.02; 1.19] Major CV events 0.69 [0.46; 1.05] All deaths 1.09 [0.59; 2.01] CV deaths 1.12 [0.52; 2.39] Stroke 0.66 [0.36; 1.20] | | Lindblad , 1991 | aspirin vs placebo | Major CV events 0.49 [0.29; 0.83] CV deaths 0.20 [0.04; 0.88] | | Non fatal stroke 0.61 [0.34; 1.11] All deaths 0.39 [0.13; 1.22] Stroke 0.61 [0.34; 1.11] | | Danish low-dose, 1986 | aspirin vs placebo | | | Non fatal stroke 0.67 [0.28; 1.59] Non fatal MI 0.00 [0.00; NaN] Major CV events 1.01 [0.57; 1.76] All deaths 1.41 [0.65; 3.07] CV deaths 1.87 [0.77; 4.56] Stroke 0.67 [0.28; 1.59] | | ESPS 2 , 1996 | aspirin vs placebo | Non fatal stroke 0.82 [0.68; 0.98] Major CV events 0.87 [0.76; 1.00] Stroke 0.82 [0.68; 0.98] | | Fatal stroke 0.91 [0.59; 1.39] Non fatal MI 0.59 [0.32; 1.06] All deaths 0.90 [0.75; 1.09] CV deaths 0.95 [0.75; 1.21] |
| Trial | Treatments | Patients | Method |
|---|
| Canadian study (CCSG), 1978 | aspirin 325 mg/d (n=144) vs. placebo (n=139) factorial design : aspirin and sulfinpyrazone | | Double blind Factorial plan Sample size: 144/139 Primary endpoint: FU duration: ND | | Swedish study , 1987 | aspirin 1,500 mg/d (n=253) vs. placebo (n=252) | | Sample size: 253/252 Primary endpoint: FU duration: 2 y | | UK-TIA low dose , 1988 | aspirin 300 mg/d (n=806) vs. placebo (n=814) | | Sample size: 806/814 Primary endpoint: FU duration: 4 y | | UK-TIA high dose , 1988 | aspirin 1,200 mg/d (n=815) vs. placebo (n=814) | | Sample size: 815/814 Primary endpoint: FU duration: 2y | | SALT , 1991 | aspirin 75 mg/d (n=676) vs. placebo (n=684) | | Sample size: 676/684 Primary endpoint: FU duration: 32 mo | | Reuther , 1976 | aspirin 1,500 mg/d (n=30) vs. placebo (n=30) | | Sample size: 30/30 Primary endpoint: FU duration: 2 y | | AITA, 1975 | aspirin 1,300 mg/d (n=162) vs. placebo (n=157) | | Sample size: 162/157 Primary endpoint: FU duration: 1 y | | DCS, 1980 | aspirin 1,000 mg/d (n=101) vs. placebo (n=102) | | Sample size: 101/102 Primary endpoint: FU duration: 25 mo | | AICLA, 1981 | aspirin 990 mg/d (n=198) vs. placebo (n=204) | | Sample size: 198/204 Primary endpoint: FU duration: 3 y | | Lindblad , 1991 | aspirin 75 mg/d, during 6 months (n=117) vs. placebo (n=115) | | Sample size: 117/115 Primary endpoint: FU duration: 6 mo | | Danish low-dose, 1986 | aspirin 50-100 mg/d (mean 54 mg/d) (n=150) vs. placebo (n=151) | | Sample size: 150/151 Primary endpoint: FU duration: 23 mo | | ESPS 2 , 1996 | aspirin 50 mg/d (n=1649) vs. placebo (n=1649) | | Sample size: 1649/1649 Primary endpoint: FU duration: 2 y |
|
| antiplatelets drug | triflusal | versus No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| T1 vs T0 | | | |
| Trial | Treatments | Patients | Method |
|---|
| TIM, 2000 | triflusal 600 mg daily (n=1135) vs. aspirine 300 mg daily (n=1140) | AMI within less than 24 h of symptom onsete | double blind Parallel groups Sample size: 1135/1140 Primary endpoint: cardiovascular events FU duration: 35 days |
|
| cholesterol lowering intervention | atorvastatin | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| SPARCL, 2006 | atorvastatin vs placebo | Major coronary event 0.68 [0.51; 0.89] Fatal stroke 0.59 [0.36; 0.97] Nonfatal or fatal stroke 0.85 [0.73; 0.99] Major cardiovascular event 0.82 [0.72; 0.94] Stroke or TIA 0.79 [0.70; 0.89] TIA 0.74 [0.60; 0.90] | | All cause death 1.02 [0.85; 1.23] cardiovascular death 0.80 [0.59; 1.07] Nonfatal stroke 0.88 [0.75; 1.04] |
| Trial | Treatments | Patients | Method |
|---|
| SPARCL, 2006 | atorvastatin 80mg daily (n=2365) vs. placebo (n=2366) | patients who had had a stroke or TIA within one to
six months before study entry, had low-density lipoprotein (LDL) cholesterol levels
of 2.6 to 4.9 mmol per liter, and had no known coronary
heart disease | double blind Parallel groups Sample size: 2365/2366 Primary endpoint: nonfatal or fatal stroke FU duration: 4.9y (median) |
|
| cholesterol lowering intervention | simvastatin | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| HPS (post troke sub group), 2004 | simvastatin vs placebo | Major cardiovascular event 0.79 [0.66; 0.95] | | Nonfatal or fatal stroke 0.99 [0.76; 1.29] |
| Trial | Treatments | Patients | Method |
|---|
| HPS (post troke sub group), 2004 | simvastatin 40mg daily (n=920) vs. placebo (n=900) | adults with cerebrovascular disease, total cholesterol >=3·5 mmol/L and without coronaro disease (n=1820) | double blind Parallel groups Sample size: 920/900 Primary endpoint: FU duration: |
|
| prevention | folic acid | versus placebo or control No demonstrated result for efficacy | 1 trial | meta-analysis | | | Trial | control | p<0.05 | harm | NS |
|---|
| VITATOPS, 2010 | folic acid, vit B12 and vit B6 vs placebo | vascular death 0.86 [0.75; 0.99] | | cardiovascular event 0.91 [0.82; 1.00] |
| Trial | Treatments | Patients | Method |
|---|
| VITATOPS, 2010 | folic acid and vitamins B12 and B6 in a single tablet (n=4089) vs. placebo (n=4075) | patients with recent stroke or TIA (within the past seven months) | double-blind Parallel groups Sample size: 4089/4075 Primary endpoint: nonfatal stroke, nonfatal MI, vascular death FU duration: 3.4 y |
|
