Table 4

Association of preventive strategies after index stroke with the primary and secondary endpoint

PatientsPreventive strategyComposite outcomeRecurrent ischaemic stroke
UnadjustedAdjusted*UnadjustedAdjusted*
OR (95%, CI)P valueN events/total N in modelaOR (95%, CI)P valueN events/total N in modelOR (95%, CI)P valueN events/ total N in modelaOR (95%, CI)P valueN events/ total N in model
All patientsUse of DOAC (vs VKA) after stroke0.49 (0.34 to 0.71)<0.001194/14980.49 (0.32 to 0.73)<0.001179/13940.51 (0.29 to 0.90)0.02069/14890.44 (0.24 to 0.80)0.00762/1368
Any anticoagulant switch0.71(0.52 to 0.96)0.024194/14980.69 (0.49 to 0.96)0.026179/13941.03 (0.62 to 1.69)0.91669/14891.03 (0.60 to 1.77)0.90962/1368
Addition of antiplatelets1.34 (0.89 to 2.03)0.164251/15641.99(1.25 to 3.15)0.004225/14482.38 (1.31 to 4.32)0.00469/15052.66 (1.40 to 5.04)0.00362/1382
Patients with DOAC at the time of the strokeSwitch to another DOAC0.83 (0.54 to 1.27)0.38094/8290.81(0.51 to 1.29)0.37286/7611.76 (0.89 to 3.47)0.10539/8261.87 (0.88 to 3.99)0.10533/757
Switch to DOAC with different dosing frequency0.65 (0.41 to 1.03)0.06989/7980.60 (0.36 to 1.00)0.05181/7301.31 (0.67 to 2.58)0.43635/7941.38 (0.64 to 2.98)0.41029/725
Switch to DOAC with different mechanism of action0.91 (0.55 to 1.52)0.72289/7991.00 (0.57 to 1.76)0.99481/7312.17 (1.09 to 4.33)0.02735/7952.12 (0.96 to 4.69)0.06329/726
Patients with VKA at the time of the strokeSwitch to any DOAC0.51 (0.33 to 0.79)0.002100/6690.55 (0.33 to 0.91)0.01993/6210.50 (0.24 to 1.06)0.07030/6630.56 (0.25 to 1.29)0.17429/611
Patients with competing stroke mechanismAddition of antiplatelets1.02 (0.56 to 1.87)0.93670/4141.88 (0.93 to 3.83)0.08063/3611.83 (0.84 to 3.99)0.12830/4092.19 (0.92 to 5.21)0.07527/359
Patients with insufficient anticoagulationSwitch to DOAC or correct DOAC dose0.84 (0.50 to 1.41)0.50169/4981.05 (0.58 to 1.90)0.87462/4670.87 (0.33 to 2.32)0.77817/4801.05 (0.35 to 3.12)0.93016/402
Patients with cardioembolism despite sufficient anticoagulationTwo times per day DOAC (vs any other anticoagulant)0.29 (0.18 to 0.45)<0.00196/6170.55 (0.31 to 0.97)0.03986/5762.20 (0.64 to 7.56)0.21221/5922.02 (0.53 to 7.69)0.30518/555
  • *Adjusted for age, sex, hypertension, diabetes, ischaemic heart disease, dyslipidaemia, renal impairment, prior ischaemic stroke, intracranial haemorrhage, current smoking, active malignancy, use of statins, use of antihypertensives.

  • .aOR, adjusted OR; DOAC, direct oral anticoagulant; VKA, vitamin K-antagonist.