1. Relation between duration of dual antiplatelet therapy and risk of ischemic stroke after stent-assisted treatment of cerebral aneurysm (DAPTS ACE-registry).
- Author
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Tomohiko Ozaki, Hiroshi Yamagami, Masafumi Morimoto, Hirotoshi Imamura, Taketo Hatano, Hidenori Oishi, Koichi Haraguchi, Shinichi Yoshimura, Tetsu Satow, Kenji Sugiu, Koji Iihara, Yuji Matsumaru, Mikito Hayakawa, Yasushi Matsumoto, Chiaki Sakai, Susumu Miyamoto, Kazuo Kitagawa, Tatsuo Kagimura, and Nobuyuki Sakai
- Subjects
INTRACRANIAL aneurysm surgery ,COMBINATION drug therapy ,RISK assessment ,INTRACRANIAL aneurysms ,RESEARCH funding ,THERAPEUTIC embolization ,LOGISTIC regression analysis ,TREATMENT duration ,SURGICAL stents ,MANN Whitney U Test ,CHI-squared test ,DESCRIPTIVE statistics ,KAPLAN-Meier estimator ,LOG-rank test ,ISCHEMIC stroke ,RESEARCH ,PLATELET aggregation inhibitors ,COMPARATIVE studies ,DATA analysis software ,CEREBRAL hemorrhage ,PROPORTIONAL hazards models ,DISEASE risk factors - Abstract
Background The optimal duration of dual antiplatelet therapy (DAPT) in patients with cerebral aneurysm who undergo stent-assisted coil embolization (SACE) has not been established. We aimed to clarify the association between duration of DAPT and incidence of ischemic stroke in patients with cerebral aneurysm. Methods We registered patients with cerebral aneurysm who underwent SACE in 27 hospitals in Japan. Those treated with DAPT (aspirin and clopidogrel) were eligible for inclusion in a previously reported randomized control trial (RCT). Patients who were ineligible or refused to participate to the RCT were followed-up for 15 months after SACE as the non-RCT cohort. Our study examined both the RCT and non-RCT cohorts. The primary and secondary outcomes were ischemic stroke and hemorrhagic events. Results Among the 313 patients registered, 296 were included for analysis (of these, 136 were RCT patients and 160 were non-RCT patients). Patients who were treated with DAPT for more than 6 months (n=191) were classified as the long-term DAPT group. Those treated less than 6 months (n=105) were classified as the short-term group. The incidence of ischemic stroke did not significantly differ between the long-term group (2.5 per 100 person-years) and the short-term group (3.2 per 100 person-years); nor did incidence of hemorrhagic events (0.8 and 3.2 per 100 person-years, respectively). The period of DAPT was not significantly associated with incidence rates of ischemic stroke or hemorrhagic events. Conclusions Duration of DAPT was not associated with the incidence of ischemic stroke in the first 15 months after SACE. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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