What is the effectiveness of anticoagulation versus antiplatelet therapy in patients with cardiomyopathy, ischemic stroke, or transient ischemic attack (TIA)?
The effectiveness of anticoagulation versus antiplatelet therapy is uncertain for patients with cardiomyopathy, ischemic stroke, or transient ischemic attack (TIA). This is because the randomized trials that evaluate the effects of antithrombotic therapy in patients with heart failure and reduced LV EF in sinus rhythm under-represent patients with history of ischemic stroke and TIA, and the primary end point always includes death which dwarfs ischemic stroke outcomes. Therefore, the choice should be individualized by taking into account the patient's bleeding risk and estimated risk of recurrent thromboembolism.