Endpoint

Incidence of stroke

CAT:outcome/stroke-incidencereported in relative risk5 findings from 5 compounds

What moved it

5 findings · 5 compounds · 2 null · by evidence strength

Compound	Direction	Findings	Strongest evidence
apixaban	no effect	1	Evidence strength: moderate. Human evidence with one recorded weakness, or capped at moderate by its design or by unread numbers.
lycopene	down	1	Evidence strength: moderate. Human evidence with one recorded weakness, or capped at moderate by its design or by unread numbers.
all-cis-5,8,11,14,17-icosapentaenoic acid	no effect	1	Evidence strength: very limited. Human evidence with major recorded weaknesses, or non-human, uncontrolled or unverified evidence.
lutein	down	1	Evidence strength: very limited. Human evidence with major recorded weaknesses, or non-human, uncontrolled or unverified evidence.
magnesium(2+)	down	1	Evidence strength: very limited. Human evidence with major recorded weaknesses, or non-human, uncontrolled or unverified evidence.

Reported to move it

3 findings

lycopene — decreases
ModerateEvidence strength: moderate. Human evidence with one recorded weakness, or capped at moderate by its design or by unread numbers.Finding
“Specifically, lycopene decreased stroke risk by 19.3% (RR = 0.807, 95% CI = 0.680–0.957), and no heterogeneity was observed (p = 0.234, I2 = 25.5%).”
Quoted verbatim from Dietary and circulating lycopene and stroke risk: a meta-analysis of prospective studies..
Study

meta-analysis
Population

Adults free of stroke at baseline in seven prospective cohort studies (four dietary lycopene, three circulating lycopene), highest versus lowest lycopene category, confounder-adjusted
Effect 0.807 risk ratio, 95% CI 0.68 to 0.957
Dietary and circulating lycopene and stroke risk: a meta-analysis of prospective studies.2014PMID:24848940Permalink
lutein — decreases
Very limitedEvidence strength: very limited. Human evidence with major recorded weaknesses, or non-human, uncontrolled or unverified evidence.Finding
“Meta-analysis showed a lower risk of coronary heart disease (pooled RR: 0.88; 95% CI: 0.80, 0.98) and stroke (pooled RR: 0.82; 95% CI: 0.72, 0.93) for the highest compared with the lowest tertile of lutein blood concentration or intake.”
Quoted verbatim from The effects of lutein on cardiometabolic health across the life course: a systematic review and meta-analysis..
Study

meta-analysis
Population

highest vs lowest tertile of lutein blood concentration or dietary intake
The effects of lutein on cardiometabolic health across the life course: a systematic review and meta-analysis.2016PMID:26762372Permalink
magnesium(2+) — decreases
Very limitedEvidence strength: very limited. Human evidence with major recorded weaknesses, or non-human, uncontrolled or unverified evidence.Finding
“An intake increment of 100 mg Mg/d was associated with an 8% reduction in risk of total stroke (combined RR: 0.92; 95% CI: 0.88, 0.97), without heterogeneity among studies (P = 0.66, I(2) = 0%).”
Quoted verbatim from Dietary magnesium intake and risk of stroke: a meta-analysis of prospective studies..
Study

meta-analysis
Dose

per 100 mg Mg/d intake increment
Population

Adults in 7 prospective cohort studies; dietary magnesium intake, total stroke (all subtypes combined)
Dietary magnesium intake and risk of stroke: a meta-analysis of prospective studies.2012PMID:22205313Permalink

Measured, no effect detected

2 findings

apixaban — no detected effect on
ModerateEvidence strength: moderate. Human evidence with one recorded weakness, or capped at moderate by its design or by unread numbers.FindingNull result
“When the cardiovascular outcomes were assessed, no significant change was observed in all-cause mortality (OR: 1.12, 95% CI: 0.89–1.40; P =.33), MACEs (OR: 0.96, 95% CI: 0.82–1.14; P =.67), stroke (OR: 0.73, 95% CI: 0.44–1.20; P =.22), stent thrombosis (OR: 0.72, 95% CI: 0.47–1.12; P =.15), and MI (OR: 0.92, 95% CI: 0.75–1.13; P =.44) when apixaban was added to DAPT as shown in Figure 4.”
Quoted verbatim from Increased bleeding events with the addition of apixaban to the dual anti-platelet regimen for the treatment of patients with acute coronary syndrome: A meta-analysis..
Study

meta-analysis
Population

Patients with acute coronary syndrome, pooled across 4 RCTs; apixaban plus aspirin and clopidogrel (DAPT) versus DAPT alone
Effect 0.73 odds ratio, 95% CI 0.44 to 1.2
Increased bleeding events with the addition of apixaban to the dual anti-platelet regimen for the treatment of patients with acute coronary syndrome: A meta-analysis.2021PMID:33761699Permalink
all-cis-5,8,11,14,17-icosapentaenoic acid — no detected effect on
Very limitedEvidence strength: very limited. Human evidence with major recorded weaknesses, or non-human, uncontrolled or unverified evidence.FindingNull result
“However, combined therapy of EPA + statin demonstrated no significant association on incidence of stroke when compared with statin alone or all-cause mortality.”
Quoted verbatim from Meta-analysis Comparing Combined Use of Eicosapentaenoic Acid and Statin to Statin Alone..
Study

meta-analysis
Population

Meta-analysis with trial sequential analysis of 5 RCTs (n=27,415) of EPA + statin vs statin alone; statin given as background therapy in both arms.
Meta-analysis Comparing Combined Use of Eicosapentaenoic Acid and Statin to Statin Alone.2020PMID:31740020Permalink

How it is measured

Incident stroke events ascertained by each source's stated adjudication criteria. Ischaemic and haemorrhagic subtypes are recorded with each finding wherever the source separates them.