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Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease
Revascularization surgery is considered a standard treatment for preventing additional stroke in symptomatic moyamoya disease (MMD). In hemodynamically stable, and asymptomatic or mildly symptomatic patients, however, the treatment strategy is controversial because of the obscure natural course of t...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481560/ https://www.ncbi.nlm.nih.gov/pubmed/34588601 http://dx.doi.org/10.1038/s41598-021-99009-1 |
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author | Pang, Chang Hwan Cho, Won-Sang Kang, Hyun-Seung Kim, Jeong Eun |
author_facet | Pang, Chang Hwan Cho, Won-Sang Kang, Hyun-Seung Kim, Jeong Eun |
author_sort | Pang, Chang Hwan |
collection | PubMed |
description | Revascularization surgery is considered a standard treatment for preventing additional stroke in symptomatic moyamoya disease (MMD). In hemodynamically stable, and asymptomatic or mildly symptomatic patients, however, the treatment strategy is controversial because of the obscure natural course of them. The authors analyzed the benefits and risks of antiplatelet medication in those patients. Medical data were retrospectively reviewed in 439 hemispheres of 243 patients with stable hemodynamic status. Overall, 121 patients (49.8%) with 222 studied hemispheres (50.6%) took antiplatelet medication. Symptomatic cerebral infarction and hemorrhage occurred in 10 (2.3%) and 30 (6.8%) hemispheres, over a mean follow-up of 62.0 ± 43.4 months (range 6–218 months). The use of antiplatelet agents was statistically insignificant in terms of symptomatic infarction, hemorrhage and improvement of ischemic symptoms. In subgroup analyses within the antiplatelet group according to drug potency and duration of medication, a longer duration of antiplatelet medication significantly improved ischemic symptoms (adjusted OR 1.02; 95% CI 1.01–1.03; p = 0.006). Antiplatelet medication failed to prevent symptomatic cerebral infarction or improve ischemic symptoms. However, antiplatelet therapy did not increase the risk of cerebral hemorrhage. |
format | Online Article Text |
id | pubmed-8481560 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-84815602021-10-01 Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease Pang, Chang Hwan Cho, Won-Sang Kang, Hyun-Seung Kim, Jeong Eun Sci Rep Article Revascularization surgery is considered a standard treatment for preventing additional stroke in symptomatic moyamoya disease (MMD). In hemodynamically stable, and asymptomatic or mildly symptomatic patients, however, the treatment strategy is controversial because of the obscure natural course of them. The authors analyzed the benefits and risks of antiplatelet medication in those patients. Medical data were retrospectively reviewed in 439 hemispheres of 243 patients with stable hemodynamic status. Overall, 121 patients (49.8%) with 222 studied hemispheres (50.6%) took antiplatelet medication. Symptomatic cerebral infarction and hemorrhage occurred in 10 (2.3%) and 30 (6.8%) hemispheres, over a mean follow-up of 62.0 ± 43.4 months (range 6–218 months). The use of antiplatelet agents was statistically insignificant in terms of symptomatic infarction, hemorrhage and improvement of ischemic symptoms. In subgroup analyses within the antiplatelet group according to drug potency and duration of medication, a longer duration of antiplatelet medication significantly improved ischemic symptoms (adjusted OR 1.02; 95% CI 1.01–1.03; p = 0.006). Antiplatelet medication failed to prevent symptomatic cerebral infarction or improve ischemic symptoms. However, antiplatelet therapy did not increase the risk of cerebral hemorrhage. Nature Publishing Group UK 2021-09-29 /pmc/articles/PMC8481560/ /pubmed/34588601 http://dx.doi.org/10.1038/s41598-021-99009-1 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Pang, Chang Hwan Cho, Won-Sang Kang, Hyun-Seung Kim, Jeong Eun Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease |
title | Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease |
title_full | Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease |
title_fullStr | Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease |
title_full_unstemmed | Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease |
title_short | Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease |
title_sort | benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8481560/ https://www.ncbi.nlm.nih.gov/pubmed/34588601 http://dx.doi.org/10.1038/s41598-021-99009-1 |
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