Evidence mapPaperPMID 42428753Full record

SynthesisFrontiers in neurology2026

Optimal pharmacological therapy for minor acute ischemic stroke: a network meta-analysis.

Shuo Feng, Shibing Liu, Hongxia Zhao, Boru Jin, Minjie Mei

Abstract readSystematic Review
In one paragraph

Synthesis in Frontiers in neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Shuo Feng *Department of Neurology, Shenyang Sujiatun District Central Hospital, Shenyang City, Liaoning, China.
Shibing Liu *Department of Neurology, Shenyang Sujiatun District Central Hospital, Shenyang City, Liaoning, China.
Hongxia ZhaoDepartment of Neurology, Shenyang Sujiatun District Central Hospital, Shenyang City, Liaoning, China.
Boru JinDepartment of Neurology, Shenyang Sujiatun District Central Hospital, Shenyang City, Liaoning, China.
Minjie MeiDepartment of Neurology, Shenyang Sujiatun District Central Hospital, Shenyang City, Liaoning, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Minor acute ischemic stroke (mAIS), typically defined as a National Institutes of Health Stroke Scale (NIHSS) score ≤ 5, accounts for over 50% of all ischemic strokes. However, the optimal pharmacological therapy for patients with mAIS remains controversial. Hence, this systematic review and network meta-analysis (NMA) was conducted to compare the effectiveness and safety of available pharmacological therapies for mAIS patients. Methods: PubMed, Embase, the Cochrane Library, and Web of Science databases were systematically searched for publications up to June 1, 2025. Randomized controlled trials (RCTs) and cohort studies investigating various antithrombotic drugs for mAIS were retrieved. The included outcome measures were functional outcomes (modified Rankin Scale [mRS] 0-1, mRS 0-2), early neurological improvement within 24 h, intracranial hemorrhage, newly diagnosed ischemic stroke within 90 days, and all-cause mortality (ACM). Bayesian NMA was performed using R 4.5.1 and STATA 15.1. Results: Eleven eligible studies, involving 26,176 patients, were included, which evaluated 9 different antithrombotic interventions. According to the NMA, single antiplatelet therapy (SAPT) (surface under the cumulative ranking curve [SUCRA] = 67.3%) and aspirin (SUCRA = 71.9%) were the most likely best interventions for achieving an mRS score of 0-1 and 0-2, respectively. Alteplase (SUCRA = 81.9%) had the highest probability of being the most effective in improving early neurological function within 24 h. Aspirin (SUCRA = 87.6%) was associated with the lowest incidence of symptomatic intracranial hemorrhage. Dual antiplatelet therapy (DAPT) represented the most likely best intervention in reducing newly diagnosed ischemic stroke within 90 days and ACM, with a SUCRA of 87.7 and 68.3%, respectively. Conclusion: Both DAPT and aspirin may represent safe and effective interventions for treating mAIS. However, individual patient circumstances should be considered in clinical decision-making. This analysis provides insights that may support the selection of individualized treatment strategies. The findings of this NMA, based on limited studies, remain to be further validated in future well-designed large-scale RCTs. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/search, identifier CRD420251238111.

Indexed as

acute ischemic strokeantiplatelet therapyantiplatelet therapy dualminorrandomized controlled trial

Identifiers

PMID42428753
PMCPMC13346836

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.