Safety and Efficacy of Baseline Antiplatelet Treatment in Patients Undergoing Mechanical Thrombectomy for Ischemic Stroke: Antiplatelets Before Mechanical Thrombectomy
Language English Country United States Media print-electronic
Document type Journal Article, Research Support, Non-U.S. Gov't
PubMed
37192724
DOI
10.1016/j.jvir.2023.05.017
PII: S1051-0443(23)00349-4
Knihovny.cz E-resources
- MeSH
- Aspirin adverse effects MeSH
- Stroke * diagnostic imaging therapy MeSH
- Intracranial Hemorrhages chemically induced MeSH
- Ischemic Stroke * diagnostic imaging therapy MeSH
- Brain Ischemia * diagnostic imaging therapy MeSH
- Clopidogrel adverse effects MeSH
- Humans MeSH
- Mechanical Thrombolysis * adverse effects MeSH
- Thrombectomy adverse effects MeSH
- Thrombolytic Therapy adverse effects MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Names of Substances
- Aspirin MeSH
- Clopidogrel MeSH
PURPOSE: To investigate the safety and efficacy of baseline antiplatelet treatment in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT). MATERIALS AND METHODS: Baseline use of antiplatelet medication before MT for (AIS) may provide benefit on reperfusion and clinical outcome but could also carry an increased risk of intracranial hemorrhage (ICH). All consecutive patients with AIS and treated with MT with and without intravenous thrombolysis (IVT) between January 2012 and December 2019 in all centers performing MT nationwide were reviewed. Data were prospectively collected in national registries (eg, SITS-TBY and RES-Q). Primary outcome was functional independence (modified Rankin Scale 0-2) at 3 months; secondary outcome was ICH. RESULTS: Of the 4,351 patients who underwent MT, 1,750 (40%) and 666 (15%) were excluded owing to missing data from the functional independence and ICH outcome cohorts, respectively. In the functional independence cohort (n = 2,601), 771 (30%) patients received antiplatelets before MT. Favorable outcome did not differ in any antiplatelet, aspirin, and clopidogrel groups when compared with that in the no-antiplatelet group: odds ratio (OR), 1.00 (95% CI, 0.84-1.20); OR, 1.05 (95% CI, 0.86-1.27); and OR, 0.88 (95% CI, 0.55-1.41), respectively. In the ICH cohort (n = 3,685), 1095 (30%) patients received antiplatelets before MT. The rates of ICH did not increase in any treatment options (any antiplatelet, aspirin, clopidogrel, and dual antiplatelet groups) when compared with those in the no-antiplatelet group: OR, 1.03 (95% CI, 0.87-1.21); OR, 0.99 (95% CI, 0.83-1.18); OR, 1.10 (95% CI, 0.82-1.47); and OR, 1.43 (95% CI, 0.87-2.33), respectively. CONCLUSIONS: Antiplatelet monotherapy before MT did not improve functional independence or increase the risk of ICH.
Center for Health Research Medical Faculty Ostrava University Ostrava Czech Republic
Department of Neurology Faculty of Medicine in Pilsen Charles University Pilsen Czech Republic
Department of Neurology Hospital Ceske Budejovice Ceske Budejovice Czech Republic
Department of Neurology Na Homolce Hospital Prague Czech Republic
Department of Radiology Palacky University Medical School and Hospital Olomouc Czech Republic
Neurocentre Regional Hospital Liberec Liberec Czech Republic
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