Antiplatelet therapy for secondary prevention in patients with ischaemic stroke and transient ischaemic attack: a retrospective cohort study in Malaysia
In this study, we evaluated clinical outcomes of antiplatelet therapy for secondary prevention in ischaemic stroke and transient ischaemic attack (TIA) patients. This was a retrospective cohort study that included patients with newly diagnosed ischaemic stroke or TIA between 2014 and 2017 using d...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Penerbit UKM
2023
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| Online Access: | http://journalarticle.ukm.my/24400/ http://journalarticle.ukm.my/24400/1/MH_12pdf_.pdf |
| Summary: | In this study, we evaluated clinical outcomes of antiplatelet therapy for secondary
prevention in ischaemic stroke and transient ischaemic attack (TIA) patients. This
was a retrospective cohort study that included patients with newly diagnosed
ischaemic stroke or TIA between 2014 and 2017 using data from routine practice
in Malaysia. Patients were grouped into single antiplatelet therapy (SAPT) and
dual antiplatelet therapy (DAPT) users. Primary outcome was composite of stroke,
myocardial infarction, and all-cause death in 90 days and 1 year. Safety outcome
was major bleeding events. Among 3344 stroke patients, 8.1% received DAPT and
91.2% received SAPT. The 1-year cumulative incidence of composite events was
16.0 and 7.2 per 100 person-years for SAPT and DAPT, respectively. Propensity
score-matched analysis of Cox hazard model showed DAPT reduced the risk of
composite event (hazard ratio (HR) 0.48; 95% CI 0.25-0.91) and recurrent stroke
(HR 0.38; 95% CI 0.16-0.92) in 1-year follow-up. Results were not significant for
myocardial infarction, all-cause death, and 90-day outcomes. The risks of bleeding
were not significantly different between SAPT and DAPT. Treatment with DAPT
after an ischaemic stroke/TIA was associated with reduced risk of the composite
events (stroke, myocardial infarction, or death) and recurrent stroke at 1 year. |
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