RT Journal Article
SR Electronic
T1 Optimal duration of dual antiplatelet therapy for minor stroke within 72 hours of symptom onset: a prospective cohort study
JF Stroke and Vascular Neurology
JO Stroke Vasc Neurol
FD BMJ Publishing Group Ltd
SP svn-2023-002933
DO 10.1136/svn-2023-002933
A1 Liu, Tingting
A1 Wang, Yongle
A1 Zhang, Kaili
A1 Fan, Haimei
A1 Li, Yanan
A1 Ren, Jing
A1 Li, Juan
A1 Li, Yali
A1 Li, Xinyi
A1 Xuemei, Wu
A1 Wang, Junhui
A1 Xue, Lixi
A1 Gao, Xiaolei
A1 Yan, Yuping
A1 Li, Gaimei
A1 Liu, Qingping
A1 Niu, Wenhua
A1 Du, Wenxian
A1 Liu, Yuting
A1 Niu, Xiaoyuan
YR 2024
UL http://svn.bmj.com/content/early/2024/09/13/svn-2023-002933.abstract
AB Objectives Despite the potential spillover effect, the optimal duration of dual antiplatelet therapy for minor stroke within 72 hours of symptom onset is still uncertain.Methods Safety and Efficacy of Aspirin-Clopidogrel in Acute Noncardiogenic Minor Ischemic Stroke (National Institutes of Health Stroke Scale (NIHSS) score≤5) is a prospective cohort study involving patients with minor ischaemic stroke within 72 hours of symptom onset. The DAPT group was further categorised into three subgroups: shorter duration (<10 days), short duration (10–21 days) and long duration (>21 days). The primary efficacy and safety outcomes were composite vascular event and severe bleeding during 90 days.Results Among 3061 eligible patients (age was 61.7±12.0 years, 73.3% were men, median (IQR) NIHSS score, 2 (1–3)), 2977 (97.4%) completed the follow-up. Dual antiplatelet therapy (DAPT) and single antiplatelet therapy (SAPT) were administered in 61.0% and 39.0% of patients. Among them, 305 patients (16.8%) received a shorter duration of DAPT, 937 patients (51.7%) received a short duration and 572 patients (31.5%) received a long duration. In the propensity-weighted Cox proportional hazards regression analysis, the use of DAPT in the short-duration group was associated with a lower risk of the primary vascular event outcome (HR (HR)=0.66, 95% CI 0.46 to 0.94, p=0.02) compared with SAPT group. The incidence of severe bleeding events at 90 days was similar. Similar findings were obtained from the propensity score-matching analysis.Conclusion Short duration of DAPT (10–21 days) is superior to SAPT in minor stroke within 72 hours, reducing 90-day composite vascular events without increasing bleeding risk.The data that support the findings of this study are available from the corresponding author upon reasonable request. The corresponding author is responsible for the data in this study.