دورية أكاديمية
أعرض في EDS

Risk of Early Bleeding with Dual Antiplatelet Therapy in Acute Stroke and Transient Ischemic Attack Regardless of NIHSS Admission.

التفاصيل البيبلوغرافية
العنوان: Risk of Early Bleeding with Dual Antiplatelet Therapy in Acute Stroke and Transient Ischemic Attack Regardless of NIHSS Admission.
المؤلفون: Scavasine VC; Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil. Electronic address: valeriascavasine@hotmail.com., Barbosa RM; Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil., Lopes Neto FDN; Statistics Center, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil., Germininani FMB; Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil., Bazan R; Neurology Division, Medical School, UNESP, Botucatu, SP, Brazil., Zétola VF; Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil., Massaro AR; Hospital Sírio Libanes, São Paulo, Brazil., Lange MC; Neurology Division, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
المصدر: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2021 May; Vol. 30 (5), pp. 105677. Date of Electronic Publication: 2021 Mar 04.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Saunders Country of Publication: United States NLM ID: 9111633 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-8511 (Electronic) Linking ISSN: 10523057 NLM ISO Abbreviation: J Stroke Cerebrovasc Dis Subsets: MEDLINE
أسماء مطبوعة: Publication: Philadelphia, PA : Saunders
Original Publication: New York, NY : Demos Publications, [1991-
مواضيع طبية MeSH: Disability Evaluation* , Patient Admission* , Time-to-Treatment*, Aspirin/*adverse effects , Clopidogrel/*adverse effects , Dual Anti-Platelet Therapy/*adverse effects , Intracranial Hemorrhages/*chemically induced , Ischemic Attack, Transient/*drug therapy , Platelet Aggregation Inhibitors/*adverse effects , Stroke/*drug therapy, Aged ; Aspirin/administration & dosage ; Brazil/epidemiology ; Clopidogrel/administration & dosage ; Databases, Factual ; Drug Administration Schedule ; Dual Anti-Platelet Therapy/mortality ; Female ; Functional Status ; Humans ; Incidence ; Intracranial Hemorrhages/diagnosis ; Intracranial Hemorrhages/mortality ; Ischemic Attack, Transient/diagnosis ; Ischemic Attack, Transient/mortality ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/administration & dosage ; Predictive Value of Tests ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stroke/diagnosis ; Stroke/mortality ; Time Factors ; Treatment Outcome
مستخلص: Background: Dual antiplatelet therapy (DAT) is a therapeutic option for patients with minor ischemic stroke (IS) or transient ischemic attack (TIA). No study has evaluated the incidence of early bleeding in patients with moderate to major ischemic stroke. The current study aimed to analyze both the frequency of early bleeding and hospital morbidity related to DAT for either acute IS or TIA regardless of admission National Institute of Health Stroke Scale (NIHSS) score.
Methods: This was a retrospective analysis based on data collected from a prospective data bank of a single center. We included patients who underwent DAT in the first 24 hours of symptom onset with a loading dose (aspirin 300 mg + clopidogrel 300 mg) on the first day, followed by a maintenance dose (aspirin 100 mg + clopidogrel 75 mg). We analyzed intracranial and/or extracranial hemorrhage that had occurred during the hospital admission, symptomatic bleeding, modified Rankin Scale (mRS) score at discharge, and death rates as outcomes.
Results: Of the 119 patients analyzed, 94 (79 %) had IS and 25 (21 %) had TIA. Hemorrhage occurred in 11 (9.2 %) and four (3.4 %) patients with TIA or NIHSS ≤ 3, respectively, although none were symptomatic. Patients with bleeding as a complication had higher admission NIHSS [4 (3-7) vs. 2 (1-4), p = 0.044] and had higher mRS at discharge (mRS 2 [1-5] vs. mRS 1 [0-2], p = 0.008). These findings did not indicate increased mortality, as one (9 %) patient died from bleeding and two (1.8 %) patients died without bleeding (p = 0.254).
Conclusion: DAT seems to be a safe therapy in patients regardless of admission NIHSS if started within the first 24 h after symptom onset because only 1.6 % of patients had symptomatic bleeding.
(Copyright © 2021 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Bleeding; Dual antiplatelet therapy; Intracranial Hemorrhages; Stroke
المشرفين على المادة: 0 (Platelet Aggregation Inhibitors)
A74586SNO7 (Clopidogrel)
R16CO5Y76E (Aspirin)
تواريخ الأحداث: Date Created: 20210307 Date Completed: 20210428 Latest Revision: 20210428
رمز التحديث: 20221213
DOI: 10.1016/j.jstrokecerebrovasdis.2021.105677
PMID: 33677312
قاعدة البيانات: MEDLINE
الوصف
تدمد:1532-8511
DOI:10.1016/j.jstrokecerebrovasdis.2021.105677