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Effect of dual antiplatelet on recurrent stroke in minor stroke or TIA depends on bodyweight

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机构: [1]Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [2]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [3]China National Clinical Research Center for Neurological Diseases, Beijing, China [4]Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China [5]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
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关键词: bodyweight dual antiplatelet therapy ischemic stroke outcomes TIA

摘要:
Objective: To assess whether bodyweight influences the efficacy and safety of dual antiplatelet therapy (DAT) in male patients with minor stroke or transient ischemic attack patients. Materials and methods: All 3,420 male participants coming from the Clopidogrel in High-Risk Patients with Acute Non-disabling Cerebrovascular Events trial were divided into 3 groups based on bodyweight (< 65 kg, 65-75 kg, and >= 75 kg). The stroke outcomes included stroke recurrence, combined vascular events, and bleeding events during 90 days of follow-up. The interaction of the treatment effects of DAT among patients with different bodyweight was assessed by Cox proportional hazards models. Results: DAT is superior to mono antiplatelet therapy (MAT) for reducing stroke recurrence among patients with weight < 65 kg (5.0% vs 11.7%; hazard ratio [HR], 0.41; 95% CI: 0.22-0.76) and 65-75 kg (6.7% vs 10.8%, HR, 0.62; 95% CI: 0.43-0.89). However, no significant difference was found in stroke recurrence between DAT and MAT in patients with weight >= 75 kg (9.4% vs 11.6%; HR, 0.80; 95% CI: 0.58-1.10). A significant interaction was observed between weight and antiplatelet therapy on stroke recurrence (p < 0.05). Similar result was found for combined vascular events. More bleeding events were found in DAT group among patients with weight < 65 kg (3.7% vs 2.2%), but with no significant difference. Conclusion: DAT does not show benefit in patients with higher weight, compared with MAT. Bleeding events found in the DAT group were not more than the MAT group among patients with lower weight.

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出版当年[2017]版:
大类 | 4 区 医学
小类 | 3 区 卫生保健与服务
最新[2023]版:
大类 | 3 区 医学
小类 | 4 区 卫生保健与服务
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出版当年[2016]版:
Q2 HEALTH CARE SCIENCES & SERVICES
最新[2023]版:
Q2 HEALTH CARE SCIENCES & SERVICES

影响因子: 最新[2023版] 最新五年平均 出版当年[2016版] 出版当年五年平均 出版前一年[2015版] 出版后一年[2017版]

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第一作者机构: [1]Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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通讯机构: [1]Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [2]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China [3]China National Clinical Research Center for Neurological Diseases, Beijing, China [4]Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China [5]Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China [*1]Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, No 6 Tiantanxili, Dongcheng District, Beijing 100050, China [*2]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No 6 Tiantanxili, Dongcheng District, Beijing 100050, China
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