دورية أكاديمية
Trends in Dual Antiplatelet Therapy of Aspirin and Clopidogrel and Outcomes in Ischemic Stroke Patients Noneligible for POINT/CHANCE Trial Treatment.
| العنوان: | Trends in Dual Antiplatelet Therapy of Aspirin and Clopidogrel and Outcomes in Ischemic Stroke Patients Noneligible for POINT/CHANCE Trial Treatment. |
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| المؤلفون: | Kim JT; Department of Neurology, Chonnam National University Hospital Chonnam National University Medical School Gwangju Korea., Lee JS; Clinical Research Center, Asan Institute for Life Sciences, Asan Medical Center University of Ulsan College of Medicine Seoul Korea., Kim H; Department of Neurology, Chonnam National University Hospital Chonnam National University Medical School Gwangju Korea., Kim BJ; Department of Neurology, Cerebrovascular Center Seoul National University Bundang Hospital Seongnam Korea., Lee KJ; Department of Neurology Korea University Guro Hospital Seoul Korea., Park JM; Department of Neurology, Uijeongbu Eulji Medical Center Eulji University School of Medicine Uijeongbu-si Korea., Kang K; Department of Neurology, Nowon Eulji Medical Center Eulji University School of Medicine Seoul Korea., Lee SJ; Department of Neurology, Eulji University Hospital Eulji University Daejeon Korea., Kim JG; Department of Neurology, Eulji University Hospital Eulji University Daejeon Korea., Cha JK; Department of Neurology Dong-A University Hospital Busan Korea., Kim DH; Department of Neurology Dong-A University Hospital Busan Korea., Park TH; Department of Neurology Seoul Medical Center Seoul Korea., Lee K; Department of Neurology, Soonchunhyang University Seoul Hospital Soonchunhyang University College of Medicine Seoul Korea., Lee J; Department of Neurology Yeungnam University Hospital Daegu Korea., Hong KS; Department of Neurology, Ilsan Paik Hospital Inje University Goyang Korea., Cho YJ; Department of Neurology, Ilsan Paik Hospital Inje University Goyang Korea., Park HK; Department of Neurology, Ilsan Paik Hospital Inje University Goyang Korea., Lee BC; Department of Neurology Hallym University Sacred Heart Hospital Anyang Korea., Yu KH; Department of Neurology Hallym University Sacred Heart Hospital Anyang Korea., Oh MS; Department of Neurology Hallym University Sacred Heart Hospital Anyang Korea., Kim DE; Department of Neurology Dongguk University Ilsan Hospital Goyang Korea., Choi JC; Department of Neurology, Jeju National University Hospital Jeju National University School of Medicine Jeju Korea., Kwon JH; Department of Neurology Ulsan University College of Medicine Ulsan Korea., Kim WJ; Department of Neurology Ulsan University College of Medicine Ulsan Korea., Shin DI; Department of Neurology Chungbuk National University Hospital Cheongju Korea., Yum KS; Department of Neurology Chungbuk National University Hospital Cheongju Korea., Sohn SI; Department of Neurology Keimyung University Dongsan Medical Center Daegu Korea., Hong JH; Department of Neurology Keimyung University Dongsan Medical Center Daegu Korea., Lee SH; Department of Neurology Hallym University Chuncheon Sacred Heart Hospital Chuncheon-si Gangwon-do Korea., Park MS; Department of Neurology, Chonnam National University Hospital Chonnam National University Medical School Gwangju Korea., Ryu WS; Artificial Intelligence Research Center JLK Inc. Seoul Korea., Park KY; Department of Neurology, Chung-Ang University College of Medicine Chung-Ang University Hospital Seoul Korea., Lee J; Department of Biostatistics Korea University College of Medicine Seoul Korea., Saver JL; Department of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine University of California Los Angeles CA., Bae HJ; Department of Neurology, Cerebrovascular Center Seoul National University Bundang Hospital Seongnam Korea. |
| المصدر: | Journal of the American Heart Association [J Am Heart Assoc] 2024 May 21; Vol. 13 (10), pp. e033611. Date of Electronic Publication: 2024 May 18. |
| نوع المنشور: | Journal Article; Multicenter Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101580524 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2047-9980 (Electronic) Linking ISSN: 20479980 NLM ISO Abbreviation: J Am Heart Assoc Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Oxford : Wiley-Blackwell |
| مواضيع طبية MeSH: | Clopidogrel*/therapeutic use , Aspirin*/therapeutic use , Ischemic Stroke*/drug therapy , Ischemic Stroke*/mortality , Ischemic Stroke*/diagnosis , Ischemic Stroke*/prevention & control , Dual Anti-Platelet Therapy*/adverse effects , Platelet Aggregation Inhibitors*/therapeutic use , Platelet Aggregation Inhibitors*/adverse effects , Registries*, Humans ; Male ; Aged ; Female ; Middle Aged ; Treatment Outcome ; Aged, 80 and over ; Time Factors ; Japan/epidemiology ; Secondary Prevention/methods ; Secondary Prevention/trends ; Drug Therapy, Combination ; Risk Factors |
| مستخلص: | Background: Recent clinical trials established the benefit of dual antiplatelet therapy with aspirin and clopidogrel (DAPT-AC) in early-presenting patients with minor ischemic stroke. However, the impact of these trials over time on the use and outcomes of DAPT-AC among the patients with nonminor or late-presenting stroke who do not meet the eligibility criteria of these trials has not been delineated. Methods and Results: In a multicenter stroke registry, this study examined yearly changes from April 2008 to August 2022 in DAPT-AC use for stroke patients ineligible for CHANCE/POINT (Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events/Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke) clinical trials due to National Institutes of Health Stroke Scale >4 or late arrival beyond 24 hours of onset. A total of 32 118 patients (age, 68.1±13.1 years; male, 58.5%) with National Institutes of Health Stroke Scale of 4 (interquartile range, 1-7) were analyzed. In 2008, DAPT-AC was used in 33.0%, other antiplatelets in 62.7%, and no antiplatelet in 4.3%. The frequency of DAPT-AC was relatively unchanged through 2013, when the CHANCE trial was published, and then increased steadily, reaching 78% in 2022, while other antiplatelets decreased to 17.8% in 2022 ( P Conclusions: Use of DAPT-AC in stroke patients with stroke ineligible for recent DAPT clinical trials increased markedly and steadily after CHANCE publication in 2013, reaching deployment in nearly 4 of every 5 patients by 2022. The secondary prevention in patients with ischemic stroke seems to be gradually improving, possibly due to the enhancement of risk factor control. |
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| فهرسة مساهمة: | Keywords: acute ischemic stroke; aspirin; clopidogrel; dual antiplatelet treatment; late‐presenting stroke; nonminor stroke |
| تواريخ الأحداث: | Date Created: 20240518 Date Completed: 20240521 Latest Revision: 20240710 |
| رمز التحديث: | 20240710 |
| مُعرف محوري في PubMed: | PMC11179811 |
| DOI: | 10.1161/JAHA.123.033611 |
| PMID: | 38761083 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 2047-9980 |
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| DOI: | 10.1161/JAHA.123.033611 |