The international surgical journal with global reach

This is the Scientific Surgery Archive, which contains all randomized clinical trials in surgery that have been identified by searching the top 50 English language medical journal issues since January 1998. Compiled by Jonothan J. Earnshaw, former Editor-in-Chief, BJS

Efficacy and safety of using dual versus monotherapy antiplatelet agents in secondary stroke prevention: systematic review and meta-analysis of randomized controlled clinical trials. Circulation 2021; 143: 2441–2453.

Published: 9th December 2021

Authors: Trifan G, Gorelick PB, Testai FD


The analysis included 27 358 patients, but the quality of evidence was moderate to low. Dual antiplatelet therapy reduced the risk of recurrent stroke (relative risk 0.71, 95 per cent confidence interval 0.63 to 0.81), but increased the risk of major bleeding (2.17; 1.45 to 3.25). Bleeding was not increased if dual antiplatelet therapy was restricted to 30 days.

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