Effect of dual versus mono antiplatelet therapy on recurrent stroke modulated by activated partial thromboplastin time
| Autor: | X, Xie, X, Wang, D T, Laskowitz, X, Zhao, Z, Miao, L, Liu, H, Li, X, Meng, Y, Wang |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Percentile Brain Ischemia 03 medical and health sciences 0302 clinical medicine Recurrence Internal medicine Outcome Assessment Health Care medicine Humans cardiovascular diseases 030212 general & internal medicine Stroke Aged Aspirin medicine.diagnostic_test Proportional hazards model business.industry Hazard ratio Middle Aged medicine.disease Clopidogrel Confidence interval Neurology Cardiology Drug Therapy Combination Female Partial Thromboplastin Time Neurology (clinical) business 030217 neurology & neurosurgery Platelet Aggregation Inhibitors circulatory and respiratory physiology medicine.drug Partial thromboplastin time |
| Zdroj: | European journal of neurology. 26(9) |
| ISSN: | 1468-1331 |
| Popis: | BACKGROUND AND PURPOSE The efficacy of dual antiplatelet treatment may be modified by many factors. The aim was to assess whether the effect of clopidogrel plus aspirin versus aspirin alone on recurrent stroke would be affected by admission activated partial thromboplastin time (aPTT). METHODS Data were derived from the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. A total of 5074 patients were categorized into three groups based on the aPTT distribution according to the 15th and 85th percentile. The primary outcome was any stroke within 90 days. The interaction of aPTT with antiplatelet therapy on stroke risk was assessed with a Cox proportional hazards model with adjustment for covariates. RESULTS In the high aPTT group (defined as ≥35.9 s), stroke occurred in 6.7% of patients in the clopidogrel-aspirin arm and 11.9% in the aspirin arm [adjusted hazard ratio (HR) 0.50; 95% confidence interval (CI) 0.29-0.85]. In the medium aPTT group (24.6-35.8 s), stroke occurred in 7.7% of patients in the clopidogrel-aspirin arm and 11.8% in the aspirin arm (adjusted HR 0.62; 95% CI 0.50-0.75). Furthermore, in the low aPTT group (≤24.5 s), stroke occurred in 11.2% of patients in the clopidogrel-aspirin arm and 9.9% in the aspirin arm (adjusted HR 1.07; 95% CI 0.65-1.62). The interaction P value of antiplatelet therapy with aPTT level at the cut-point of approximately 25 s or below was significant (P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text