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Oral anticoagulation is beneficial for stroke patients with confirmed atrial fibrillation, but when a cardioembolic source is merely suspected but not proven, the picture is less clear. Any potential role of non–vitamin K antagonist oral anticoagulants (NOACs) to treat embolic stroke of undetermined source (ESUS) is critically dependent on the specific risk for intracranial hemorrhage associated with each NOAC compared with standard aspirin therapy.
Therefore, investigators performed a partially industry-funded systematic review and meta-analysis of randomized clinical trials to compare the hemorrhage risks of specific NOACs with that of aspirin. The analysis included 5 randomized trials totaling 39,398 participants. No trials directly compa…