Cargando…

Efficacy of aspirin, clopidogrel, and ticlopidine in stroke prevention: A population-based case-cohort study in Taiwan

BACKGROUND: In real-world practice settings, there is insufficient evidence on the efficacy of antiplatelet drugs, including clopidogrel, aspirin, and ticlopidine, in stroke prevention. PURPOSE: To compare the efficacies between aspirin and clopidogrel and aspirin and ticlopidine in stroke preventio...

Descripción completa

Detalles Bibliográficos
Autores principales: Wong, Yi-Sin, Tsai, Ching-Fang, Hsu, Yueh-Han, Ong, Cheung-Ter
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769270/
https://www.ncbi.nlm.nih.gov/pubmed/33370282
http://dx.doi.org/10.1371/journal.pone.0242466
_version_ 1783629286561808384
author Wong, Yi-Sin
Tsai, Ching-Fang
Hsu, Yueh-Han
Ong, Cheung-Ter
author_facet Wong, Yi-Sin
Tsai, Ching-Fang
Hsu, Yueh-Han
Ong, Cheung-Ter
author_sort Wong, Yi-Sin
collection PubMed
description BACKGROUND: In real-world practice settings, there is insufficient evidence on the efficacy of antiplatelet drugs, including clopidogrel, aspirin, and ticlopidine, in stroke prevention. PURPOSE: To compare the efficacies between aspirin and clopidogrel and aspirin and ticlopidine in stroke prevention. METHODS: This population-based case-cohort study utilized the data obtained from a randomized sample of one million subjects in the Taiwan National Health Insurance Research Database. Patients who were hospitalized owing to the primary diagnosis of ischemic stroke from January 1, 2000 to December 31, 2010 and treated with aspirin, ticlopidine, or clopidogrel were included in the study. Propensity score matching with a 1:4 ratio was performed to compare aspirin with ticlopidine and clopidogrel. The criteria for inclusion were the use of one of the three antiplatelet drugs for more than 14 days within the first month after the stroke and then continued use of the antiplatelet drugs until the study endpoint of recurrent stroke. RESULTS: During the 3-year follow-up period, the recurrent stroke rates were 1.62% (42/2585), 1.48% (3/203), and 2.55% (8/314) in the aspirin, ticlopidine, and clopidogrel groups, respectively. Compared with the patients treated with aspirin, those treated with clopidogrel and ticlopidine showed competing risk-adjusted hazard ratios of recurrent stroke of 2.27 (1.02–5.07) and 0.62 (0.08–4.86), respectively. CONCLUSION: Compared with the patients treated with aspirin, those treated with clopidogrel were at a higher risk of recurrent stroke. For stroke prevention, aspirin was superior to clopidogrel whereas ticlopidine was not inferior to aspirin.
format Online
Article
Text
id pubmed-7769270
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-77692702021-01-08 Efficacy of aspirin, clopidogrel, and ticlopidine in stroke prevention: A population-based case-cohort study in Taiwan Wong, Yi-Sin Tsai, Ching-Fang Hsu, Yueh-Han Ong, Cheung-Ter PLoS One Research Article BACKGROUND: In real-world practice settings, there is insufficient evidence on the efficacy of antiplatelet drugs, including clopidogrel, aspirin, and ticlopidine, in stroke prevention. PURPOSE: To compare the efficacies between aspirin and clopidogrel and aspirin and ticlopidine in stroke prevention. METHODS: This population-based case-cohort study utilized the data obtained from a randomized sample of one million subjects in the Taiwan National Health Insurance Research Database. Patients who were hospitalized owing to the primary diagnosis of ischemic stroke from January 1, 2000 to December 31, 2010 and treated with aspirin, ticlopidine, or clopidogrel were included in the study. Propensity score matching with a 1:4 ratio was performed to compare aspirin with ticlopidine and clopidogrel. The criteria for inclusion were the use of one of the three antiplatelet drugs for more than 14 days within the first month after the stroke and then continued use of the antiplatelet drugs until the study endpoint of recurrent stroke. RESULTS: During the 3-year follow-up period, the recurrent stroke rates were 1.62% (42/2585), 1.48% (3/203), and 2.55% (8/314) in the aspirin, ticlopidine, and clopidogrel groups, respectively. Compared with the patients treated with aspirin, those treated with clopidogrel and ticlopidine showed competing risk-adjusted hazard ratios of recurrent stroke of 2.27 (1.02–5.07) and 0.62 (0.08–4.86), respectively. CONCLUSION: Compared with the patients treated with aspirin, those treated with clopidogrel were at a higher risk of recurrent stroke. For stroke prevention, aspirin was superior to clopidogrel whereas ticlopidine was not inferior to aspirin. Public Library of Science 2020-12-28 /pmc/articles/PMC7769270/ /pubmed/33370282 http://dx.doi.org/10.1371/journal.pone.0242466 Text en © 2020 Wong et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Wong, Yi-Sin
Tsai, Ching-Fang
Hsu, Yueh-Han
Ong, Cheung-Ter
Efficacy of aspirin, clopidogrel, and ticlopidine in stroke prevention: A population-based case-cohort study in Taiwan
title Efficacy of aspirin, clopidogrel, and ticlopidine in stroke prevention: A population-based case-cohort study in Taiwan
title_full Efficacy of aspirin, clopidogrel, and ticlopidine in stroke prevention: A population-based case-cohort study in Taiwan
title_fullStr Efficacy of aspirin, clopidogrel, and ticlopidine in stroke prevention: A population-based case-cohort study in Taiwan
title_full_unstemmed Efficacy of aspirin, clopidogrel, and ticlopidine in stroke prevention: A population-based case-cohort study in Taiwan
title_short Efficacy of aspirin, clopidogrel, and ticlopidine in stroke prevention: A population-based case-cohort study in Taiwan
title_sort efficacy of aspirin, clopidogrel, and ticlopidine in stroke prevention: a population-based case-cohort study in taiwan
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7769270/
https://www.ncbi.nlm.nih.gov/pubmed/33370282
http://dx.doi.org/10.1371/journal.pone.0242466
work_keys_str_mv AT wongyisin efficacyofaspirinclopidogrelandticlopidineinstrokepreventionapopulationbasedcasecohortstudyintaiwan
AT tsaichingfang efficacyofaspirinclopidogrelandticlopidineinstrokepreventionapopulationbasedcasecohortstudyintaiwan
AT hsuyuehhan efficacyofaspirinclopidogrelandticlopidineinstrokepreventionapopulationbasedcasecohortstudyintaiwan
AT ongcheungter efficacyofaspirinclopidogrelandticlopidineinstrokepreventionapopulationbasedcasecohortstudyintaiwan