机构:[1]Capital Med Univ, Beijing TianTan Hosp, Dept Neurol, Tiantan Clin Trial & Res Ctr Stroke, 6 Tiantanxili, Beijing 100050, Peoples R China;重点科室诊疗科室神经病学中心首都医科大学附属天坛医院[2]Capital Med Univ, Beijing TianTan Hosp, Dept Neurol, Vasc Neurol, 6 Tiantan Xili, Beijing 100050, Peoples R China;重点科室诊疗科室神经病学中心首都医科大学附属天坛医院[3]Capital Med Univ, Beijing TianTan Hosp, Dept Neurol, Neurointens Care Unit, Beijing, Peoples R China;重点科室诊疗科室神经病学中心首都医科大学附属天坛医院[4]China Natl Clin Res Ctr Neurol Dis, Beijing, Peoples R China;国家神经系统疾病临床医学研究中心国家神经系统疾病临床医学研究中心首都医科大学附属天坛医院[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;重点科室诊疗科室神经病学中心首都医科大学附属天坛医院[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
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.
基金:
Ministry of Science and Technology of the People's Republic of ChinaMinistry of Science and Technology, China [2008ZX09312-008, 200902004, 2011BAI08B01, 2011BA I08B02, 2012ZX09303, 2013BAI09B03]; Beijing Institute for Brain Disorders [BIBD-PXM2013_014226_07_000084]; Beijing Municipal Key Laboratory for Neural Regeneration and Repairing [2015SJZS05]
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;
推荐引用方式(GB/T 7714):
Li Zixiao,Wang Yilong,Zhao Xingquan,et al.Treatment Effect of Clopidogrel Plus Aspirin Within 12 Hours of Acute Minor Stroke or Transient Ischemic Attack[J].JOURNAL OF THE AMERICAN HEART ASSOCIATION.2016,5(3):-.doi:10.1161/JAHA.115.003038.
APA:
Li, Zixiao,Wang, Yilong,Zhao, Xingquan,Liu, Liping,Wang, David...&Wang, Yongjun.(2016).Treatment Effect of Clopidogrel Plus Aspirin Within 12 Hours of Acute Minor Stroke or Transient Ischemic Attack.JOURNAL OF THE AMERICAN HEART ASSOCIATION,5,(3)
MLA:
Li, Zixiao,et al."Treatment Effect of Clopidogrel Plus Aspirin Within 12 Hours of Acute Minor Stroke or Transient Ischemic Attack".JOURNAL OF THE AMERICAN HEART ASSOCIATION 5..3(2016):-