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Risks and benefits of clopidogrel-aspirin in minor stroke or TIA Time course analysis of CHANCE

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机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China; [2]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [3]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China; [4]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China; [5]Capital Med Univ, Sch Publ Hlth, Dept Epidemiol & Hlth Stat, Beijing, Peoples R China; [6]Univ Illinois, Coll Med, INI Stroke Network, OSF Healthcare Syst, Peoria, IL 61656 USA; [7]Univ Texas Austin, Dell Med Sch, Austin, TX 78712 USA
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Objective: To investigate the short-term time course risks and benefits of clopidogrel with aspirin in minor ischemic stroke or TIA. Methods: Data were derived from the Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. The primary outcome was a new ischemic stroke. Safety outcomes included any bleeding and moderate to severe bleeding. Time course analyses were performed for the outcomes of both stroke and bleeding. Results: A total of 145 (71.1%), 13 (6.4%), and 12 (5.9%) of 204 new ischemic strokes in the clopidogrel-aspirin group vs 223 (75.6%), 19 (6.4%), and 8 (2.7%) of 295 in the aspirin alone group occurred at the first, second, and third week, respectively. A total of 23 (38.3%), 15 (25.0%), and 9 (15.0%) of 60 bleeding cases in the clopidogrel-aspirin group vs 15 (36.6%), 8 (19.5%), and 3 (7.3%) of 41 in the aspirin alone group occurred at the first, second, and third week, respectively. Clopidogrel-aspirin treatment numerically reduced the risk of ischemic stroke within the first 2 weeks. From the 10th day, the number of any bleeding cases caused by dual antiplatelets outweighed that of new stroke reduced by dual antiplatelets. Conclusions: Clopidogrel-aspirin treatment may have a benefit of reducing stroke risk outweighing the potential risk of increased bleeding especially within the first 2 weeks compared with aspirin alone in patients with minor stroke or TIA.

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出版当年[2016]版:
大类 | 1 区 医学
小类 | 1 区 临床神经病学
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 临床神经病学
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出版当年[2015]版:
Q1 CLINICAL NEUROLOGY
最新[2023]版:
Q1 CLINICAL NEUROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

第一作者:
第一作者机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China; [2]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [3]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China; [4]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China; [5]Capital Med Univ, Sch Publ Hlth, Dept Epidemiol & Hlth Stat, Beijing, Peoples R China;
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China; [2]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [3]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China; [4]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China;
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