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Safety and efficacy of oral antiplatelet for patients who had acute ischaemic stroke undergoing endovascular therapy

BACKGROUND AND PURPOSE: To investigate the safety and efficacy of oral antiplatelet therapy (APT) for patients who had acute ischaemic stroke (AIS), receiving endovascular therapy (EVT). METHODS: Patients were divided into non-APT group and APT (single APT or dual APT (DAPT)) group. The safety and e...

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Detalles Bibliográficos
Autores principales: Huo, Xiaochuan, ­, Raynald, Jing, Jing, Wang, Anxin, Mo, Dapeng, Gao, Feng, Ma, Ning, Wang, Yilong, Wang, Yongjun, Miao, Zhongrong
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8258061/
https://www.ncbi.nlm.nih.gov/pubmed/34057905
http://dx.doi.org/10.1136/svn-2020-000466
Descripción
Sumario:BACKGROUND AND PURPOSE: To investigate the safety and efficacy of oral antiplatelet therapy (APT) for patients who had acute ischaemic stroke (AIS), receiving endovascular therapy (EVT). METHODS: Patients were divided into non-APT group and APT (single APT or dual APT (DAPT)) group. The safety and efficacy endpoints at 3-month follow-up were symptomatic intracranial haemorrhage (sICH), recanalisation rate, clinical outcome and mortality. RESULTS: Among 915 patients who had AIS, those in APT group (n=199) showed shorter puncture-to-recanalisation time, lower frequency of intravenous thrombolysis and more use of tirofiban compared with those in non-antiplatelet group (n=716) (p<0.05 for all). Oral APT was found to be associated with superior clinical outcome compared with non-APT (APT (44.2%) versus non-APT (41.1%)), adjusted OR=2.605, 95% CI 1.244 to 5.455, p=0.011). DAPT showed superior clinical outcome compared with non-APT (DAPT (56.5%) versus non-APT (41.1%), adjusted OR=5.405, 95% CI 1.614 to 18.102, p=0.006) and lower risk of mortality at 3-month follow-up (DAPT (4.8%) versus non-DAPT (17.7%), adjusted OR=0.008, 95% CI 0.000 to 0.441, p=0.019). There was no significant difference in sICH between the two groups. CONCLUSIONS: Oral APT prior to undergoing EVT is safe and may accompany with superior clinical outcomes. DAPT may associate with superior clinical outcomes and lower risk of mortality.