机构:[1]Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China诊疗科室心脏及大血管病中心首都医科大学附属天坛医院[2]Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China重点科室诊疗科室神经病学中心神经病学中心首都医科大学附属天坛医院[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
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.
基金:
Ministry of Science and Technology of the People's Republic of ChinaMinistry of Science and Technology, China [2016YFC1307300, 2013BAI09B03, 2011BAI08B02]; Beijing Municipal Administration of Hospitals' Youth Programme [QML2015 0504]
第一作者机构:[1]Department of Cardiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
通讯作者:
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
推荐引用方式(GB/T 7714):
Ma Yan,Liu Ying,Xu Jie,et al.Effect of dual antiplatelet on recurrent stroke in minor stroke or TIA depends on bodyweight[J].THERAPEUTICS AND CLINICAL RISK MANAGEMENT.2018,14:861-870.doi:10.2147/TCRM.S156694.
APA:
Ma, Yan,Liu, Ying,Xu, Jie,Wang, Yilong,Wang, Yongjun&Du, Fenghe.(2018).Effect of dual antiplatelet on recurrent stroke in minor stroke or TIA depends on bodyweight.THERAPEUTICS AND CLINICAL RISK MANAGEMENT,14,
MLA:
Ma, Yan,et al."Effect of dual antiplatelet on recurrent stroke in minor stroke or TIA depends on bodyweight".THERAPEUTICS AND CLINICAL RISK MANAGEMENT 14.(2018):861-870