Episode 346: 245. Duration of benefit and risk of dual antiplatelet therapy after mild ischemic stroke
Questioning Medicine20 Marras 2024

Episode 346: 245. Duration of benefit and risk of dual antiplatelet therapy after mild ischemic stroke

And now a secondary analysis of the trial focused on the timing of major ischemic events and the potential tradeoffs of benefits and risks,------ maybe there is magic sauce where the benefit is drastically greater than risk and vice versa!

Guan L et al. Duration of benefit and risk of dual antiplatelet therapy up to 72 hours after mild ischemic stroke and transient ischemic attack. Neurology 2024 Oct 8; 103:e209845. (https://doi.org/10.1212/WNL.0000000000209845)

The goal is less ischemic events with the DAPT but there is a risk of more bleeding and maybe if we tease out the data we can find the exact right time—not too much, not too little but just right.

They found the benefit of decrease ischemic stroke

was front-loaded, with roughly a 1.5% absolute risk reduction (ARR) for major ischemic events in the first week, a 0.5% ARR in the second week, and a nonsignificant 0.29% ARR in the third week.

The bleeding risk was constant right around ARR 0.1%

Thus three weeks remains reasonable to rec DAPT—remember at three weeks the decrease ischemic event rate in absolute terms was 0.3 and the bleeding risk was around 0.1……. the real magic does appear to be in the first week when the risk of repeart event is around 1.5%

Jaksot(385)

Episode 415: 422. Finerenone restores fertility?

Episode 415: 422. Finerenone restores fertility?

Lin Z, et al. Antifibrotic drug finerenone restores fertility in premature ovarian insufficiency. Science 2026 Feb 5; 391:eadz4075. DOI: 10.1126/science.adz4075. Premature ovarian insufficiency is usu...

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Episode 414: 421. Scabies and DUKE criteria

Episode 414: 421. Scabies and DUKE criteria

Stavropoulou E, et al. Reassessing the 2023 International Society for Cardiovascular Infectious Diseases Duke clinical criteria for infective endocarditis: Impact of excluding fever and updating diagn...

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Episode 413: 420. Frail and CODE LVO PLUS antibiotics don't help viral illness

Episode 413: 420. Frail and CODE LVO PLUS antibiotics don't help viral illness

we look at CODE LVO and what does being frail even mean?????vaccines may not help baby and antibiotics still don't help viral illness

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Episode 412: CME song --Check the Lytes

Episode 412: CME song --Check the Lytes

CME song --Check the Lytes

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Episode 411: CME - sodium, potassium, calcium

Episode 411: CME - sodium, potassium, calcium

CME - sodium, potassium, calcium

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Episode 410: 418.  Beta Blockers Post MI, PSA, Youtube,

Episode 410: 418. Beta Blockers Post MI, PSA, Youtube,

10.1016/j.jaip.2025.07.005.40675327All of the videos were found to be useful or very useful, 99% were of moderate or high reliability, and 99% had moderate to excellent educational quality  Prostate-s...

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Episode 409: 417. Aspirin, Pre-diabetes, Menopause, Type 1 Diabetes, HPV Vaccine and more!!!!

Episode 409: 417. Aspirin, Pre-diabetes, Menopause, Type 1 Diabetes, HPV Vaccine and more!!!!

Wolfe R, Broder JC, Zhou Z, et al. Aspirin, cardiovascular events, and major bleeding in older adults: extended follow-up of the ASPREE trial. Eur Heart J. 12 Aug 2025. [Epub ahead of print]. https://...

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Episode 408: 416. Car Seats, Beta-Blockers after a Heart Attack, Oral Semaglutide, High-Dose influenza vaccine

Episode 408: 416. Car Seats, Beta-Blockers after a Heart Attack, Oral Semaglutide, High-Dose influenza vaccine

Beta-Blockers after Myocardial Infarction without Reduced Ejection Fraction - https://www.nejm.org/doi/full/10.1056/NEJMoa2504735?query=WB  McGuire DK et al. Oral semaglutide and cardiovascular outcom...

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