Comparative Effectiveness of Dual Antiplatelet Therapy With Aspirin and Clopidogrel Versus Aspirin Monotherapy in Mild-to-Moderate Acute Ischemic Stroke According to the Risk of Recurrent Stroke An Analysis of 15 000 Patients From a Nationwide, Multicenter Registry
DC Field | Value | Language |
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dc.contributor.author | Lee, Hak-Loh | - |
dc.contributor.author | Kim, Joon-Tae | - |
dc.contributor.author | Lee, Ji Sung | - |
dc.contributor.author | Park, Man-Seok | - |
dc.contributor.author | Choi, Kang-Ho | - |
dc.contributor.author | Cho, Ki-Hyun | - |
dc.contributor.author | Kim, Beom Joon | - |
dc.contributor.author | Park, Jong-Moo | - |
dc.contributor.author | Kang, Kyusik | - |
dc.contributor.author | Lee, Soo Joo | - |
dc.contributor.author | Kim, Jae Guk | - |
dc.contributor.author | Cha, Jae-Kwan | - |
dc.contributor.author | Kim, Dae-Hyun | - |
dc.contributor.author | Park, Tai Hwan | - |
dc.contributor.author | Park, Sang-Soon | - |
dc.contributor.author | Lee, Kyung Bok | - |
dc.contributor.author | Lee, Jun | - |
dc.contributor.author | Hong, Keun-Sik | - |
dc.contributor.author | Cho, Yong-Jin | - |
dc.contributor.author | Park, Hong-Kyun | - |
dc.contributor.author | Lee, Byung-Chul | - |
dc.contributor.author | Yu, Kyung-Ho | - |
dc.contributor.author | Oh, Mi Sun | - |
dc.contributor.author | Kim, Dong-Eog | - |
dc.contributor.author | Ryu, Wi-Sun | - |
dc.contributor.author | Choi, Jay Chol | - |
dc.contributor.author | Kwon, Lee-Hyun | - |
dc.contributor.author | Kim, Wook-Joo | - |
dc.contributor.author | Shin, Dong-Ick | - |
dc.contributor.author | Sohn, Sung Il | - |
dc.contributor.author | Hong, Jeong-Ho | - |
dc.contributor.author | Lee, Juneyoung | - |
dc.contributor.author | Bae, Hee-Joon | - |
dc.date.available | 2021-02-19T06:44:27Z | - |
dc.date.issued | 2020-11 | - |
dc.identifier.issn | 1941-7713 | - |
dc.identifier.issn | 1941-7705 | - |
dc.identifier.uri | https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/51844 | - |
dc.description.abstract | Background: This study compared the effectiveness of dual antiplatelet therapy (DAPT) with clopidogrel-aspirin with that of aspirin monotherapy (AM) in mild-to-moderate acute ischemic stroke considering the risk of recurrent stroke using the Stroke Prognosis Instrument II (SPI-II) score. Methods: This study is a retrospective analysis of data from a prospective, nationwide, multicenter stroke registry database between January 2011 and July 2018. We included patients with mild-to-moderate (National Institutes of Health Stroke Scale score <= 10), acute (within 24 hours of onset), noncardioembolic ischemic stroke. The primary outcome was a 3-month composite of stroke (either hemorrhagic or ischemic), myocardial infarction, and all-cause mortality. Propensity scores using the inverse probability of treatment weighting method were used to mitigate baseline imbalances between the DAPT and AM groups and within each subgroup considering SPI-II scores. Results: Among the 15 430 patients (age, 66 +/- 13 years; men, 62.0%), 45.1% (n=6960) received DAPT and 54.9% (n=8470) received AM. Primary outcome events were significantly more frequent in the AM group (16.7%) than in the DAPT group (15.5%; P=0.03). Weighted Cox proportional hazards models showed a reduced risk of 3-month primary vascular events in the DAPT group versus the AM group (hazard ratio, 0.84 [0.78-0.92]; P<0.001), with no interaction between acute treatment type and SPI-II risk subgroups (P-interaction=0.44). However, among the high-risk patients with SPI-II scores >7, a substantially larger absolute benefit was observed for 3-month composite vascular events in the DAPT group (weighted absolute risk differences, 5.4%), whereas smaller absolute benefits were observed among patients in the low- or medium-risk SPI-II subgroups (1.7% and 2.4%, respectively). Conclusions: Treatment with clopidogrel-aspirin was associated with a reduction in 3-month vascular events compared with AM in mild-to-moderate acute noncardioembolic ischemic stroke patients. Larger magnitudes of the effects of DAPT with clopidogrel-aspirin were observed in the high-risk subgroup by SPI-II risk scores. | - |
dc.format.extent | 11 | - |
dc.language | 영어 | - |
dc.language.iso | ENG | - |
dc.publisher | Lippincott Williams & Wilkins Ltd. | - |
dc.title | Comparative Effectiveness of Dual Antiplatelet Therapy With Aspirin and Clopidogrel Versus Aspirin Monotherapy in Mild-to-Moderate Acute Ischemic Stroke According to the Risk of Recurrent Stroke An Analysis of 15 000 Patients From a Nationwide, Multicenter Registry | - |
dc.type | Article | - |
dc.publisher.location | 미국 | - |
dc.identifier.doi | 10.1161/CIRCOUTCOMES.119.006474 | - |
dc.identifier.scopusid | 2-s2.0-85096348848 | - |
dc.identifier.wosid | 000591405400006 | - |
dc.identifier.bibliographicCitation | Circulation. Cardiovascular quality and outcomes, v.13, no.11, pp 853 - 863 | - |
dc.citation.title | Circulation. Cardiovascular quality and outcomes | - |
dc.citation.volume | 13 | - |
dc.citation.number | 11 | - |
dc.citation.startPage | 853 | - |
dc.citation.endPage | 863 | - |
dc.type.docType | Article | - |
dc.description.isOpenAccess | N | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Cardiovascular System & Cardiology | - |
dc.relation.journalWebOfScienceCategory | Cardiac & Cardiovascular Systems | - |
dc.subject.keywordPlus | TRANSIENT ISCHEMIA | - |
dc.subject.keywordPlus | INSTRUMENT-II | - |
dc.subject.keywordPlus | PREDICTION | - |
dc.subject.keywordPlus | MANAGEMENT | - |
dc.subject.keywordPlus | SUBTYPE | - |
dc.subject.keywordPlus | COHORT | - |
dc.subject.keywordPlus | ATTACK | - |
dc.subject.keywordPlus | DEATH | - |
dc.subject.keywordAuthor | aspirin | - |
dc.subject.keywordAuthor | clopidogrel | - |
dc.subject.keywordAuthor | prognosis | - |
dc.subject.keywordAuthor | prospective studies | - |
dc.subject.keywordAuthor | registries | - |
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