1. Trends in Dual Antiplatelet Therapy of Aspirin and Clopidogrel and Outcomes in Ischemic Stroke Patients Noneligible for POINT/CHANCE Trial Treatment.
- Author
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Kim, Joon-Tae, Lee, Ji, Kim, Hyunsoo, Kim, Beom, Lee, Keon-Joo, Park, Jong-Moo, Kang, Kyusik, Lee, Soo, Kim, Jae, Cha, Jae-Kwan, Kim, Dae-Hyun, Park, Tai, Lee, Kyungbok, Lee, Jun, Hong, Keun-Sik, Cho, Yong-Jin, Park, Hong-Kyun, Lee, Byung-Chul, Yu, Kyung-Ho, Oh, Mi, Kim, Dong-Eog, Choi, Jay, Kwon, Jee-Hyun, Kim, Wook-Joo, Shin, Dong-Ick, Yum, Kyu, Sohn, Sung, Hong, Jeong-Ho, Lee, Sang-Hwa, Park, Man-Seok, Ryu, Wi-Sun, Park, Kwang-Yeol, Lee, Juneyoung, Saver, Jeffrey, and Bae, Hee-Joon
- Subjects
acute ischemic stroke ,aspirin ,clopidogrel ,dual antiplatelet treatment ,late‐presenting stroke ,nonminor stroke ,Humans ,Clopidogrel ,Aspirin ,Male ,Aged ,Female ,Ischemic Stroke ,Dual Anti-Platelet Therapy ,Platelet Aggregation Inhibitors ,Registries ,Middle Aged ,Treatment Outcome ,Aged ,80 and over ,Time Factors ,Japan ,Secondary Prevention ,Drug Therapy ,Combination ,Risk Factors - Abstract
BACKGROUND: Recent clinical trials established the benefit of dual antiplatelet therapy with aspirin and clopidogrel (DAPT-AC) in early-presenting patients with minor ischemic stroke. However, the impact of these trials over time on the use and outcomes of DAPT-AC among the patients with nonminor or late-presenting stroke who do not meet the eligibility criteria of these trials has not been delineated. METHODS AND RESULTS: In a multicenter stroke registry, this study examined yearly changes from April 2008 to August 2022 in DAPT-AC use for stroke patients ineligible for CHANCE/POINT (Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events/Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke) clinical trials due to National Institutes of Health Stroke Scale >4 or late arrival beyond 24 hours of onset. A total of 32 118 patients (age, 68.1±13.1 years; male, 58.5%) with National Institutes of Health Stroke Scale of 4 (interquartile range, 1-7) were analyzed. In 2008, DAPT-AC was used in 33.0%, other antiplatelets in 62.7%, and no antiplatelet in 4.3%. The frequency of DAPT-AC was relatively unchanged through 2013, when the CHANCE trial was published, and then increased steadily, reaching 78% in 2022, while other antiplatelets decreased to 17.8% in 2022 (Ptrend
- Published
- 2024