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.
基金:
Ministry of Science and Technology of the People's Republic of ChinaMinistry of Science and Technology, China [2013BAI09B03, 2013BAI09B14, 2015BAI12B04, 2015BAI12B02]; Beijing Biobank of Cerebral Vascular Disease [D131100005313003]; Beijing Institute for Brain Disorders [1152130306]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81322019]; Beijing Municipal Science and Technology CommissionBeijing Municipal Science & Technology Commission [D131100002313002, D151100002015001, D151100002015002, D151100002015003, Z15110200390000, Z151100003915117]; Beijing Municipal Commission of Health and Family Planning [2016-1-2041, SML20150502]
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;
推荐引用方式(GB/T 7714):
Pan Yuesong,Jing Jing,Chen Weiqi,et al.Risks and benefits of clopidogrel-aspirin in minor stroke or TIA Time course analysis of CHANCE[J].NEUROLOGY.2017,88(20):1906-1911.doi:10.1212/WNL.0000000000003941.
APA:
Pan, Yuesong,Jing, Jing,Chen, Weiqi,Meng, Xia,Li, Hao...&Wang, Yongjun.(2017).Risks and benefits of clopidogrel-aspirin in minor stroke or TIA Time course analysis of CHANCE.NEUROLOGY,88,(20)
MLA:
Pan, Yuesong,et al."Risks and benefits of clopidogrel-aspirin in minor stroke or TIA Time course analysis of CHANCE".NEUROLOGY 88..20(2017):1906-1911