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Discontinuation of antiplatelet therapy after stent-assisted coil embolisation of cerebral aneurysm:a nationwide cohort study

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Stroke & Vascular Neurology 2024年第5期9卷 560-567页

作者： Minyoul Baik Jimin Jeon Jinkwon Kim joonsang yoo Department of Neurology Yongin Severance HospitalYonsei University College of MedicineYongin-siGyeonggi-doKorea(the Republic of)

Introduction Stent-assisted coil embolisation(SACE)for the treatment of unruptured cerebral aneurysms has been increasingly ***-term advantages of antiplatelet therapy(APT)post-SACE treatment are still not well *** investigated the long-term effects of APT on clinical prognosis after *** and methods We conducted a retrospective study using nationwide health insurance claims data from South Korea,including patients with cerebral aneurysm treated with SACE from January 2009 to December *** study outcomes consisted of the occurrence of cerebral infarction and major *** evaluate the impact of APT,we employed a multivariable time-dependent Cox proportional hazards regression model for each of the three distinct periods:1–12 months,12–24 months and>24 months after *** This study included 17692 unruptured cerebral aneurysm patients treated with *** the mean follow-up of 4.2 years,there were 379(2.1%)patients with cerebral infarction and 190(1.1%)patients with major *** percentage of patients receiving APT was 79.5%at 1year,which gradually decreased to 58.3%at 2 years after *** was beneficial in preventing cerebral infarction within 12 months after SACE(adjusted HR(aHR)0.56;95%CI,0.35 to 0.89;p=0.014).After 12 months,this association was not *** increased the risk of haemorrhage after 24 months(aHR 1.76;95%CI 1.11 to 2.87;p=0.016).Discussion and conclusion Our findings suggest that in patients with unruptured cerebral aneurysm treated with SACE,the reasonable duration of APT for preventing cerebral infarction might be 1year after SACE.

关键词： cerebral aneurysm nationwide

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Association between statin therapy and the risk of stroke in patients with moyamoya disease:a nationwide cohort study

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Stroke & Vascular Neurology 2023年第4期8卷 276-283,I0010-I0021页

作者： joonsang yoo Jimin Jeon Minyoul Baik Jinkwon Kim Department of Neurology Yongin Severance HospitalYonsei College of MedicineYongin-siKorea(the Republic of) Institute for Innovation in Digital Healthcare Yonsei UniversitySeoulKorea(the Republic of)

Background and objective Knowledge regarding the pharmacological treatment for moyamoya disease(MMD),a chronic and progressive cerebrovascular disease conferring greater stroke risk,is *** the present study,whether statin therapy is associated with a reduced risk of stroke in patients with MMD was *** This was a retrospective cohort study in which the occurrence of stroke in patients with newly diagnosed MMD was investigated using the nationwide health insurance database in Korea from January 2007 to March 2021.A multivariable Cox proportional hazards regression model was constructed for stroke,in which statin therapy after MMD diagnosis was treated as a time-dependent *** was done for sex,age,presence of comorbidities,concurrent stroke,revascularisation surgery and treatment with *** The present study included 13373 newly diagnosed patients with MMD;40.8%had a concurrent stroke at the time of MMD *** the mean follow-up of 5.1±3.3 years,631 patients(4.7%)suffered a stroke event(haemorrhagic stroke:458 patients,ischaemic stroke:173 patients).Statin therapy after MMD diagnosis was significantly associated with a reduced risk of stroke(adjusted HR 0.74;95%CI 0.60 to 0.91,p=0.004).In the secondary outcome analysis,the risk of haemorrhagic stroke(adjusted HR 0.74;95%CI 0.58 to 0.95,p=0.018)and ischaemic stroke(adjusted HR 0.75;95%CI 0.52 to 1.08,p=0.124)were reduced with the statin *** statins was also associated with a lower risk of all-cause mortality(adjusted HR 0.47;95%CI 0.33 to 0.67,p<0.001).Conclusion In patients with MMD,statin therapy was associated with a reduced risk of subsequent *** findings indicate statin treatment may be beneficial for patients with MMD,however the results should be confirmed in randomised controlled trials.

关键词： patients diagnosis nationwide

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