Comparative effectiveness of combined antiplatelet treatments in acute minor ischaemic stroke
作者机构：Department of NeurologyChonnam National University HospitalChonnam National University Medical SchoolGwangjuKorea Clinical Research CenterAsan Institute for Life SciencesAsan Medical CenterUniversity of Ulsan College of MedicineSeoulKorea Department of NeurologyCerebrovascular CenterSeoul National University Bundang HospitalSeongnamKorea Department of NeurologyUijeongbu Eulji Medical CenterEulji University School of MedicineUijeongbu-siKorea Department of NeurologyNowon Eulji Medical CenterEulji UniversitySeoulKorea Department of NeurologyEulji University HospitalEulji UniversityDaejeonKorea Department of NeurologyDong-a UniversityBusanKorea Department of NeurologySeoul Medical CenterSeoulKorea Department of NeurologySoonchunhyang University HospitalSeoulKorea Department of NeurologyYeungnam University HospitalDaeguKorea Department of NeurologyInje University Ilsan Paik HospitalInje University College of MedicineGoyangKorea Department of NeurologyHallym University Sacred Heart HospitalAnyangKorea Department of NeurologyDongguk University Ilsan HospitalGoyangKorea Department of NeurologyJeju National University HospitalJeju National University School of MedicineJejuKorea Department of NeurologyUniversity of Ulsan College of MedicineUlsanKorea Department of NeurologyChungbuk National University HospitalCheongjuKorea Department of NeurologyKeimyung University Dongsan Medical CenterDaeguKorea Department of BiostatisticsKorea University College of MedicineSeoulKorea
出 版 物：《Stroke & Vascular Neurology》 (卒中与血管神经病学（英文）)
年 卷 期：2022年第7卷第1期
页 面：13-21页
核心收录：
学科分类：1002[医学-临床医学] 100215[医学-康复医学与理疗学] 100204[医学-神经病学] 10[医学]
基 金：supported by funding(2020ER620200#)from Research of Korea Centers for Disease Control and Prevention the Chong Kun Dang Pharmaceutical Corp.(Seoul,Korea).
主 题：prevention treatment alone
摘 要：Background No study has thoroughly compared the effectiveness of combined antiplatelet treatments(other than clopidogrel–aspirin)versus clopidogrel–aspirin or aspirin alone for early secondary prevention in acute ischaemic stroke.Methods We identified patients with acute,minor,non-cardiogenic ischaemic stroke treated with aspirin alone,clopidogrel–aspirin or other combination treatment.Propensity scores considering the inverse probability of treatment weighting were used to adjust for baseline imbalances.The primary outcome was the composite of all strokes(ischaemic or haemorrhagic),myocardial infarction and all-cause mortality at 3 months.Results Among 12234 patients(male:61.9%;age:65.5±13 years)who met the eligibility criteria,aspirin,clopidogrel–aspirin and other combination treatments were administered in 52.2%,42.9%and 4.9%of patients,respectively.In the crude analysis,the primary outcome event at 3 months occurred in 14.5%of the other combination group,14.4%of the aspirin group and 13.0%of the clopidogrel–aspirin group.In the weighted Cox proportional hazards analysis,the 3-month primary outcome event occurred less frequently in the clopidogrel–aspirin group than in the other combination group(weighted HR:0.82(0.59–1.13)),while no association was found between the aspirin group(weighted HR:1.04(0.76–1.44))or other combination group and the 3-month primary outcome.Conclusion Other combined antiplatelet treatment,compared with aspirin alone or clopidogrel–aspirin,was not associated with reduced risks of primary composite vascular events or recurrent stroke during the first 3 months after stroke.Therefore,the results suggest that other combination treatments,particularly the cilostazol-based combination,may not be effective alternatives for clopidogrel–aspirin to prevent early vascular events in patients with acute minor stroke.Further exploration in clinical trials will be needed.
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