Best of JAMA 2025: Episode 4:Residual Risk of Recurrent Stroke Despite Anticoagulation in Patients With Atrial Fibrillation A Systematic Review and Meta-Analysis

This meta-analysis investigates the residual risk of recurrent stroke in patients with atrial fibrillation who are already receiving modern medical treatment. Despite the widespread use of blood thinners, the study reveals that patients remain at a significant disadvantage, with roughly one in six individuals suffering another ischemic event within five years. The data highlights a particularly high vulnerability for those who experience a stroke while already on anticoagulants, suggesting that current therapies may not be sufficient for all patients. Ultimately, the researchers call for advanced secondary prevention strategies and a deeper investigation into the biological drivers of these persistent cardiovascular threats.