{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T23:52:04Z","timestamp":1785369124178,"version":"3.55.0"},"reference-count":25,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2018,7,6]],"date-time":"2018-07-06T00:00:00Z","timestamp":1530835200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81471206"],"award-info":[{"award-number":["81471206"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>There is a lack of age\u2010specific evidence regarding the efficacy and safety of dual antiplatelet therapy (<jats:styled-content style=\"fixed-case\">DAPT<\/jats:styled-content>). A systematic review and meta\u2010analysis was conducted for dual versus mono antiplatelet therapy in elderly patients with ischaemic stroke (<jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content>) or transient ischaemic attack (<jats:styled-content style=\"fixed-case\">TIA<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>PubMed, <jats:styled-content style=\"fixed-case\">Embase<\/jats:styled-content> and the Cochrane Central Register of Controlled Trials were searched for relevant studies. Risk ratios (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content>s) for the outcomes of stroke recurrence, major bleeding and intracranial bleeding were calculated based on the DerSimonian and Laird random effects model. Subgroup analyses were conducted.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In seven multicentre, randomized controlled trials comprising 24\u00a0873 patients with <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">TIA<\/jats:styled-content>, aged 65\u00a0years or older, a significant reduction in the risk of recurrent stroke was observed using <jats:styled-content style=\"fixed-case\">DAPT<\/jats:styled-content> in comparison with aspirin monotherapy [<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 0.79, 95% confidence interval (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>) 0.69\u20130.91; <jats:italic>P\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.001]. <jats:styled-content style=\"fixed-case\">DAPT<\/jats:styled-content> was not associated with a significant reduction in recurrent stroke compared with clopidogrel monotherapy (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 1.01, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.93\u20131.10; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.800). In addition, the results from two studies showed that <jats:styled-content style=\"fixed-case\">DAPT<\/jats:styled-content> significantly increased the risk of major bleeding and intracranial bleeding in elderly patients over younger patients (<jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 2.18, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.02\u20134.69; and <jats:styled-content style=\"fixed-case\">RR<\/jats:styled-content> 2.13, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.18\u20133.86, respectively).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>For stroke prevention in elderly patients with <jats:styled-content style=\"fixed-case\">IS<\/jats:styled-content> or <jats:styled-content style=\"fixed-case\">TIA<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> DAPT<\/jats:styled-content> is superior to aspirin monotherapy but appears to be equivalent to clopidogrel monotherapy, and is accompanied by an increased risk of bleeding. The balance between the benefits and risks of <jats:styled-content style=\"fixed-case\">DAPT<\/jats:styled-content> is important to consider when choosing antiplatelet strategy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.13695","type":"journal-article","created":{"date-parts":[[2018,6,1]],"date-time":"2018-06-01T07:39:02Z","timestamp":1527838742000},"page":"1276-1284","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Efficacy and safety of dual antiplatelet therapy in the elderly for stroke prevention: a systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0114-8157","authenticated-orcid":false,"given":"L.","family":"Ding","sequence":"first","affiliation":[{"name":"Department of Neurology Peking Union Medical College Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Neurology Peking Union Medical College Hospital Chinese Academy of Medical Sciences Peking Union Medical College Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,7,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32152-9"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(91)90008-L"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijs.12150"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004199"},{"key":"e_1_2_8_6_1","doi-asserted-by":"crossref","first-page":"e004764","DOI":"10.1161\/JAHA.116.004764","article-title":"Risk of inhospital stroke or death is associated with age but not sex in patients treated with carotid endarterectomy for asymptomatic or symptomatic stenosis in routine practice: secondary data analysis of the nationwide German statutory quality assurance database from 2009 to 2014","volume":"6","author":"Schmid S","year":"2017","journal-title":"J Am Heart Assoc"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1524-4733.2009.00529.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.114.000912"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.003187"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000024"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pjnns.2013.11.001"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.895342"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)30770-5"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-151-4-200908180-00135"},{"key":"e_1_2_8_15_1","unstructured":"HigginsJPT AltmanDG SterneJAC. 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