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Treatment Effect of Clopidogrel Plus Aspirin Within 12 Hours of Acute Minor Stroke or Transient Ischemic Attack

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机构: [1]Capital Med Univ, Beijing TianTan Hosp, Dept Neurol, Tiantan Clin Trial & Res Ctr Stroke, 6 Tiantanxili, Beijing 100050, Peoples R China; [2]Capital Med Univ, Beijing TianTan Hosp, Dept Neurol, Vasc Neurol, 6 Tiantan Xili, Beijing 100050, Peoples R China; [3]Capital Med Univ, Beijing TianTan Hosp, Dept Neurol, Neurointens Care Unit, Beijing, Peoples R China; [4]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China; [5]Univ Illinois, Coll Med, Illinois Neurol, Inst Stroke Network,Sisters Order St Francis Heal, Peoria, IL 61656 USA; [6]Capital Med Univ, Beijing Tiantan Hosp, Dept Neuropsychiat & Behav Neurol & Clin Psychol, Beijing, Peoples R China; [7]Beijing Inst Brain Disorders, Ctr Stroke, Beijing, Peoples R China; [8]Beijing Key Lab Translat Med Cerebrovasc Dis, Beijing, Peoples R China; [9]Duke Univ, Duke Clin Res Inst, Durham, NC USA; [10]Univ Calif San Francisco, Dept Neurol, San Francisco, CA USA; [11]Univ Calif San Francisco, Dept Epidemiol, San Francisco, CA USA
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关键词: acute cerebral infarction antiplatelets transient ischemic attacks trials

摘要:
Background-The aim of this study was to analyze the benefits and safety associated with the combination therapy of clopidogrel and aspirin among minor stroke or transient ischemic attack patients treated within 12 hours. Methods and Results-This was a subanalysis of the CHANCE (Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events) trial, mainly limited to the prespecified group of patients randomized within 12 hours to either the combination of clopidogrel plus aspirin or aspirin alone. The primary outcome was ischemic stroke during 90-day follow-up. Recurrent ischemic stroke and progressive ischemic stroke were analyzed. Multivariable Cox modeling showed that randomization within 12 hours was an independent predictor of ischemic stroke events (hazard ratio [95% CI] 1.25 [1.04-1.49], P=0.02). Among 2573 patients randomized within 12 hours, 282 (10.96%) patients had ischemic stroke events. Among them, 158 (12.34%) of 1280 patients taking aspirin experienced ischemic stroke compared with 124 (9.59%) of 1293 patients taking clopidogrel-aspirin (P=0.02). The dual antiplatelet was more effective than aspirin alone in reducing the risk of recurrent ischemic stroke (6.57% versus 8.91%, P=0.03) but not progressive ischemic stroke (3.02% versus 3.43%, P=0.28). There was no significant difference in hemorrhagic events (P=0.39). Conclusions-Among patients treated within 12 hours, the combination of clopidogrel and aspirin was more effective than aspirin alone in reducing the risk of recurrent ischemic stroke during the 90-day follow-up and did not increase the hemorrhagic risk.

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出版当年[2015]版:
大类 | 2 区 医学
小类 | 3 区 心脏和心血管系统
最新[2023]版:
大类 | 1 区 医学
小类 | 2 区 心脏和心血管系统
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出版当年[2014]版:
Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
最新[2023]版:
Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

影响因子: 最新[2023版] 最新五年平均 出版当年[2014版] 出版当年五年平均 出版前一年[2013版] 出版后一年[2015版]

第一作者:
第一作者机构: [1]Capital Med Univ, Beijing TianTan Hosp, Dept Neurol, Tiantan Clin Trial & Res Ctr Stroke, 6 Tiantanxili, Beijing 100050, Peoples R China; [4]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China;
通讯作者:
通讯机构: [1]Capital Med Univ, Beijing TianTan Hosp, Dept Neurol, Tiantan Clin Trial & Res Ctr Stroke, 6 Tiantanxili, Beijing 100050, Peoples R China; [2]Capital Med Univ, Beijing TianTan Hosp, Dept Neurol, Vasc Neurol, 6 Tiantan Xili, Beijing 100050, Peoples R China; [4]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China;
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