{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T06:05:33Z","timestamp":1780380333808,"version":"3.54.1"},"reference-count":31,"publisher":"Korean Stroke Society","issue":"2","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003625","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","award":["RS-2023-00265497"],"award-info":[{"award-number":["RS-2023-00265497"]}],"id":[{"id":"10.13039\/501100003625","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["j-stroke.org"],"crossmark-restriction":true},"short-container-title":["J Stroke"],"published-print":{"date-parts":[[2026,5,31]]},"abstract":"<jats:p>Background and Purpose Patients with ischemic stroke with both atrial fibrillation (AF) and large artery atherosclerosis (LAA) represent therapeutic challenges, and the optimal antithrombotic regimen remains uncertain. We conducted a meta-analysis comparing oral anticoagulant (OAC) monotherapy with OAC plus antiplatelet therapy in this population.Methods PubMed and EMBASE were searched through June 30, 2025, for studies enrolling patients with ischemic stroke and evidence of both AF and LAA. Outcomes included recurrent ischemic stroke, major bleeding, all-cause mortality, and a composite outcome. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using the Peto method, with random-effects sensitivity analyses, stratified by short-term (&lt;3 months) and long-term (\u22651 year) follow-up.Results Eight cohort studies were analyzed. In the short-term, combination therapy was associated with a reduced risk of recurrent ischemic stroke (OR, 0.37; 95% CI, 0.14\u20130.97; P=0.043), without a significant increase in major bleeding, although this association did not persist under random-effects sensitivity analysis (OR, 0.37; 95% CI, 0.13\u20131.07; P=0.067). Conversely, long-term combination therapy was associated with higher risks of major bleeding (OR, 1.25; 95% CI, 1.08\u20131.45; P=0.002), all-cause mortality (OR, 1.25; 95% CI, 1.01\u20131.54; P=0.039), and composite outcome (OR, 1.49; 95% CI, 1.27\u20131.74; P&lt;0.001), without reducing recurrent ischemic stroke (OR, 1.12; 95% CI, 1.00\u20131.26; P=0.054).Conclusions While long-term OAC plus antiplatelet therapy increases bleeding risk without preventing recurrent stroke, short-term combination therapy may offer benefits in selected patients with concomitant LAA, though this early efficacy signal should be interpreted with caution.<\/jats:p>","DOI":"10.5853\/jos.2025.04609","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:10:39Z","timestamp":1780013439000},"page":"303-311","update-policy":"https:\/\/doi.org\/10.5853\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Combined Oral Anticoagulant and Antiplatelet for Atrial Fibrillation and Cerebral Atherosclerosis: A Meta-Analysis"],"prefix":"10.5853","volume":"28","author":[{"given":"Hyungwoo","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Neurology, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JoonNyung","family":"Heo","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Wook","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo Suk","family":"Nam","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yonsei University College of Medicine, Seoul, Korea"},{"name":"Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5750-2616","authenticated-orcid":true,"given":"Young Dae","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Neurology, Yonsei University College of Medicine, Seoul, Korea"},{"name":"Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3882","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1161\/01.str.24.1.35"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/s1474-4422(13)70310-7"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1161\/hs1201.100209"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2023.100786"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.4330\/wjc.v15.i5.229"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1177\/0003319718791711"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.120.032232"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-023-07433-4"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-023-51013-3"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s12975-020-00822-z"},{"key":"ref11","first-page":"812","volume-title":"Optimal use of antithrombotic agents in ischemic stroke 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