ESOC 2026 | Optimizing secondary stroke prevention: considerations for anticoagulation and effect of colchicine

We are mainly going to address in that session the role of anticoagulant drugs. And one of the questions that has been around for a long, long time is, is it safe or not to start sooner or later the anticoagulants in patients that have an ischemic infarct? So one of the communications gathered data, did the meta-analysis from the other studies that have analyzed this question. And what they see or they’re finding is that actually it is safe. The question is, it seems to be safe in patients that don’t have a hemorrhagic transformation. But what about patients that have, for example, hemorrhagic transformation, like for example, a P1 or P2 in the ECAS scale, is it also safe or not? So probably that’s the main question for the future. Another important drug that you are going to talk about is about colchicine. Colchicine is an anti-inflammatory drug that’s being used in other pathologies, for example, in rheumatic fever and things like that to reduce inflammation. But actually here, there’s some data that’s been gathered that shows actually that it may also be useful to reduce stroke recurrence so CONVINCE was a clinical trial that was called to see if they actually reduced strokes there after being used they weren’t able to show a significant difference mainly because they weren’t able to complete their sample size that they had predefined. But there’s lots of data from other studies, maybe in cardiology, that showed it may be useful to reduce stroke recurrence. One of the questions is, can it be useful in all types of ischemic stroke, or are there some specific etiologies that may benefit the most from colchicine? So we are talking about advances. Probably colchicine will be the first anti-inflammatory drug to be used, but much more will definitely come into the future.

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