BACKGROUND: The latest guidelines do not make clear recommendations on the selection of antiplatelet therapies for long-term secondary prevention of @entity64 . We aimed to integrate the available evidence to create hierarchies of the comparative efficacy and safety of long-term antiplatelet therapies after @entity385 or transient @entity63 attack. METHODS AND RESULTS: We performed a network meta-analysis of randomized controlled trials to compare 11 antiplatelet therapies in @entity1 with @entity385 or transient @entity63 attack. In December 2014, we searched Medline, Embase, and the Cochrane Library database for trials. The search identified 24 randomized controlled trials including a total of 85 667 patients with antiplatelet treatments for at least 1 year. @entity1924 significantly reduced @entity64 recurrence in comparison with @entity117 (odds ratio 0.66, 95% credible interval 0.44 to 0.92) and @entity4341 (odds ratio 0.57, 95% credible interval 0.34 to 0.95), respectively. @entity1924 also significantly reduced @entity932 compared with @entity117 , @entity1397 , @entity26671 , @entity1396 , @entity117 plus @entity1397 , and @entity117 plus @entity4341 . @entity117 plus @entity1397 could not significantly reduce @entity64 recurrence compared with monotherapies but caused significantly more @entity548 than all monotherapies except terutroban. The pooled estimates did not change materially in the sensitivity analyses of the primary efficacy outcome. CONCLUSIONS: Long-term monotherapy was a better choice than long-term dual therapy, and @entity1924 had the best risk-benefit profile for long-term secondary prevention after @entity64 or transient @entity63 attack. More randomized controlled trials in non-East Asian @entity1 are needed to determine whether long-term use of @entity1924 is the best option for the prevention of recurrent @entity64 .

Long-Term Antiplatelet Mono- and Dual Therapies After @entity385 or Transient XXXX Attack: Network Meta-Analysis.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity64 :: ('MESH:D020521', 'Disease') :: ['stroke'] @entity932 :: ('MESH:D020300', 'Disease') :: ['intracranial hemorrhage'] @entity1396 :: ('MESH:D013988', 'Chemical') :: ['ticlopidine'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemic'] @entity548 :: ('MESH:D006470', 'Disease') :: ['major bleeding'] @entity1397 :: ('MESH:C055162', 'Chemical') :: ['clopidogrel'] @entity117 :: ('MESH:D001241', 'Chemical') :: ['Aspirin', 'aspirin'] @entity4341 :: ('MESH:D004176', 'Chemical') :: ['dipyridamole'] @entity1924 :: ('MESH:C045645', 'Chemical') :: ['Cilostazol', 'cilostazol'] @entity26671 :: ('MESH:C501362', 'Chemical') :: ['terutroban'] @entity385 :: ('MESH:D002544', 'Disease') :: ['ischemic stroke']
@entity63 :: (MESH:D007511,Disease) :: ['Ischemic']
