Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

1,187 questions · 1,248 findings · 108 reviews · Stroke

No studies found 275 · 22%GRADE not reported 56 · 4.5%Very low 269 · 21.6%Low 349 · 28%Moderate 216 · 17.3%High 83 · 6.7%

Standard‐dose VKA plus single antiplatelet agent vs vitamin K antagonist (VKA)

Strokea · people with antiphospholipid syndrome and a history of stroke or thromboembolic events

Standard‐dose VKA plus single antiplatelet agent showed no clear difference in strokea compared with standard‐dose VKA (low certainty).

1 finding from 1 review

Standard‐dose VKA plus single antiplatelet agent vs vitamin K antagonist (VKA)

Minor bleedingb · people with antiphospholipid syndrome and a history of stroke or thromboembolic events

Standard‐dose VKA plus single antiplatelet agent showed no clear difference in minor bleedingb compared with standard‐dose VKA (low certainty).

1 finding from 1 review

NOAC (rivaroxaban) vs vitamin K antagonist (VKA)

Major bleeding · people with antiphospholipid syndrome and a history of stroke or thromboembolic events

NOAC (rivaroxaban) showed no clear difference in major bleeding compared with standard‐dose VKA (moderate certainty).

1 finding from 1 review

Standard‐dose VKA plus single antiplatelet agent vs one antiplatelet agent

Major bleeding (minor cerebral hemorrhage) · people with antiphospholipid syndrome, with previous stroke

It is very uncertain whether standard‐dose VKA plus single antiplatelet agent changes major bleeding (minor cerebral hemorrhage) compared with single antiplatelet agent (very low certainty).

1 finding from 1 review

Standard‐dose VKA plus single antiplatelet agent vs one antiplatelet agent

Stroke · people with antiphospholipid syndrome, with previous stroke

It is very uncertain whether standard‐dose VKA plus single antiplatelet agent changes stroke compared with single antiplatelet agent (very low certainty).

1 finding from 1 review

Standard‐dose VKA plus single antiplatelet agent vs one antiplatelet agent

Any bleeding that does not meet criteria for major bleeding ‐ Gastrointestinal bleeding (no definition) · people with antiphospholipid syndrome, with previous stroke

It is very uncertain whether standard‐dose VKA plus single antiplatelet agent changes any bleeding that does not meet criteria for major bleeding ‐… compared with single antiplatelet agent (very low certainty).

1 finding from 1 review

Standard‐dose VKA plus single antiplatelet agent vs dual antiplatelet agent

Stroke · people with antiphospholipid syndrome, with previous stroke

It is very uncertain whether standard‐dose VKA plus single antiplatelet agent changes stroke compared with dual antiplatelet agent (very low certainty).

1 finding from 1 review

NOAC (rivaroxaban) vs vitamin K antagonist (VKA)

Total mortalitya · people with antiphospholipid syndrome and a history of stroke or thromboembolic events

NOAC (rivaroxaban) showed no clear difference in all‐cause mortalitya compared with standard‐dose VKA (moderate certainty).

1 finding from 1 review

NOAC (rivaroxaban) vs vitamin K antagonist (VKA)

Clinically relevant non‐major bleeding Treatment duration 28 ‐ 42 days · people with antiphospholipid syndrome and a history of stroke or thromboembolic events

NOAC (rivaroxaban) showed no clear difference in clinically relevant non‐major bleeding compared with standard‐dose VKA (moderate certainty).

1 finding from 1 review

Anticoagulant drugs: VKA high dose vs vitamin K antagonist (VKA)

Thromboembolic events · people with antiphospholipid syndrome and a history of stroke or thromboembolic events

High‐dose VKA showed no clear difference in any thromboembolic event compared with standard‐dose VKA (low certainty).

1 finding from 1 review

Anticoagulant drugs: VKA high dose vs vitamin K antagonist (VKA)

Major bleeding · people with antiphospholipid syndrome and a history of stroke or thromboembolic events

High‐dose VKA showed no clear difference in major bleeding compared with standard‐dose VKA (low certainty).

1 finding from 1 review

Intervention not reported

Number of patients with all vascular events (stroke, MI, non‐fatal cardiac arrest, unstable angina requiring revascularisation, vascular death) at 90 days and at 1 year · patients with TIA or ischaemic stroke

The review found no eligible studies for this question.

1 finding from 1 review