Seoul National University Hospital
Neurology & Critical Care Medicine
Tae Jung Kim, MD, PhD Assistant Professor Department of Critical Care Medicine (Neurology) Seoul National University Hospital

Presenter of 1 Presentation

OPTIMAL ANTIPLATELET THERAPY FOR SECONDARY PREVENTION OF ISCHEMIC STROKE IN PATIENTS WHILE ON THE SINGLE ANTIPLATELET AGENT BASED ON LINKED DATA

Session Type
Oral Presentations
Date
27.10.2021, Wednesday
Session Time
10:40 - 12:00
Room
ORAL PRESENTATIONS 1
Lecture Time
11:30 - 11:40

Abstract

Background and Aims

Selecting the optimal antiplatelet therapy in ischemic stroke patients while on single antiplatelet therapy (SAPT) before stroke for long-term outcomes remains to be elucidated. This study aimed to evaluate the effect of multiple antiplatelet therapy on recurrent ischemic stroke and composite and safety outcomes in acute non-cardioembolic ischemic stroke already on SAPT using the linked big dataset on stroke in Korea.

Methods

We identified 9,284 acute non-cardioembolic ischemic stroke patients with SAPT history from January 2008 to December 2014. The included patients were categorized into three groups including SAPT, dual antiplatelet therapy (DAPT), and triple antiplatelet therapy (TAPT) according to antiplatelet therapy after acute stroke. Recurrent ischemic stroke, composite outcomes including ischemic stroke, myocardial infarction, intracerebral hemorrhage and death, and major bleedings at 1 year were outcomes.

Results

Among patients, 59.9% continued SAPT, 39.2% were treated with DAPT, and 0.9% were treated with TAPT. Compared with maintaining SAPT, no difference was observed in the risks of 1-year recurrent stroke (DAPT, HR, 1.08 [95% CI, 0.92–1.27], P = 0.339; TAPT, HR, 0.71 [95% CI, 0.27–1.91], P = 0.500) and 1-year composite outcomes according to the antiplatelet agents. However, the DAPT and TAPT groups showed an increased risk of major bleeding (DAPT, HR, 1.21 [95% CI, 0.87–1.68], P = 0.248; TAPT, HR, 4.57 [95% CI, 1.98–10.54], P < 0.001).

Conclusions

Adding antiplatelet agents had no benefit on the 1-year incidence of composite outcomes and recurrent stroke, although it caused a higher rate of bleeding events in acute non-cardioembolic ischemic stroke patients who were already on SAPT.

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