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Discontinuation of antiplatelet therapy after stent-assisted coil embolisation of cerebral aneurysm: a nationwide cohort study

Minyoul Baik, Jimin Jeon, Jinkwon Kim, Joonsang Yoo
DOI: 10.1136/svn-2023-002882 Published 5 November 2024
Minyoul Baik
Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Korea (the Republic of)
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Jimin Jeon
Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Korea (the Republic of)
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Jinkwon Kim
Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Korea (the Republic of)
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Joonsang Yoo
Department of Neurology, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin-si, Gyeonggi-do, Korea (the Republic of)
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  • Figure 1
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    Figure 1

    Flow chart describing the patient inclusion criteria. SACE, stent-assisted coil embolisation.

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    Figure 2

    Daily antiplatelet use since stent-assisted coil embolisation.

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    Figure 3

    Cumulative incidence of cerebral infarction (A), and major haemorrhage (B) according to APT. Simon and Makuch plot showed no difference in the risk of cerebral infarction according to APT (Mantel-Byar test, p=0.999, A). APT increased the risk of major haemorrhage (Mantel-Byar test, p<0.001, B). APT, antiplatelet therapy; SACE, stent assisted coil embolisation.

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    Figure 4

    Plot of estimated time-varying HRs of APT for cerebral infarction (A), and major haemorrhage (B) after SACE for unruptured cerebral aneurysm. Plots show simulated time-varying multivariable HRs of APT as a red solid line and the CIs of central 50% (dark red) and 95% (light red) as shaded areas. APT, antiplatelet therapy; SACE, stent-assisted coil embolisation.

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  • Table 1

    Impact of antiplatelet therapy on primary outcomes

    Cerebral infarction (n=379)Major haemorrhage (n=190)
    No at riskEvent noaHR (95% CI)P valueNo at riskEvent noaHR (95% CI)P value
    1–12 months17 6921410.56 (0.35 to 0.89)0.01417 692683.69 (0.89 to 15.36)0.072
    12–24 months15 679970.73 (0.48 to 1.12)0.14415 750391.23 (0.60 to 2.52)0.568
    >24 months12 3331411.01 (0.72 to 1.43)0.93312 453831.76 (1.11 to 2.87)0.016
    • Data were obtained from multivariable time-dependent Cox proportional hazards regression model for the development of outcome. The reference is the absence of APT during this period. Adjustments were made for age, sex, insurance status, hypertension, diabetes, congestive heart failure, chronic renal disease, hepatic disease, chronic obstructive lung disease, and cancer, and use of statin.

    • aHR, adjusted HR; APT, antiplatelet therapy.

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    [svn-2023-002882supp001.pdf]

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Stroke and Vascular Neurology: 9 (5)
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Discontinuation of antiplatelet therapy after stent-assisted coil embolisation of cerebral aneurysm: a nationwide cohort study
Minyoul Baik, Jimin Jeon, Jinkwon Kim, Joonsang Yoo
Stroke and Vascular Neurology Oct 2024, 9 (5) 560-567; DOI: 10.1136/svn-2023-002882

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Discontinuation of antiplatelet therapy after stent-assisted coil embolisation of cerebral aneurysm: a nationwide cohort study
Minyoul Baik, Jimin Jeon, Jinkwon Kim, Joonsang Yoo
Stroke and Vascular Neurology Oct 2024, 9 (5) 560-567; DOI: 10.1136/svn-2023-002882
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Discontinuation of antiplatelet therapy after stent-assisted coil embolisation of cerebral aneurysm: a nationwide cohort study
Minyoul Baik, Jimin Jeon, Jinkwon Kim, Joonsang Yoo
Stroke and Vascular Neurology Oct 2024, 9 (5) 560-567; DOI: 10.1136/svn-2023-002882
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