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Combined clopidogrel-aspirin treatment for high risk TIA or minor stroke does not increase cerebral microbleeds

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机构: [1]First Peoples Hosp Taizhou, Dept Neurol, Zhejing, Peoples R China; [2]Capital Med Univ, Beijing Tiantan Hosp, Dept Neurol, Beijing, Peoples R China
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关键词: Cerebral microbleeds High-risk TIA or minor stroke Clopidogrel-Aspirin

摘要:
Objectives: To study whether Clopidogrel-Aspirin combined treatment for high risk transient ischaemic attack (TIA) or minor stroke results in increased number of lesions associated with anti-thrombotic cerebral haemorrhage or cerebral micro-bleeds (CMB) than aspirin alone treatment. Methods: The patients recruited in CHANCE test in our hospital participated in this study. We made a comparison between treatments Aspirin-Clopidogrel combined group and the Aspirin alone group in the numbers of CMB and subsequent cerebral haemorrhages. In addition, we analysed the association between the increased numbers of CMB and subsequent intracerebral haemorrhages. All 129 patients with high risk TIA with microbleeds or minor stroke within 24 hours after the onset (average age 65.9 +/- 9.3, 48.7% were male patients) were divided randomly into two groups: (1) 67 patients were given combination therapy with clopidogrel and aspirin (clopidogrel at an initial dose of 300 mg, then 75 mg per day for 90 days, plus aspirin at a dose of 75 mg per day for the first 21 days);(2) the rest patients were given aspirin treatment (75 mg per day for 90 days). All participants received open-label aspirin at a clinician-determined dose of 75-300 mg on the first day. Results: The CMB were found in 52.7% of all patients in both groups. There was no siginificant difference between the Aspirin group and the Aspirin-clopidogrel treated group, though the latter showed some slight increase in CMB (Odds ratios (OR) = 1.16, 95% confidence intervals (CI) = 0.54-2.47, P=0.71). But the numbers of CMB were remarkably associated with the number of primary existing CMB (OR=6.46, 95% CI 2.57-16.23, P<0.001), especially that of primary existing CMB >= 3. In addition, the increasing numbers of CMB associated with primary CMB lesions, which located in corticosubcortical area (CSC) (OR=4.69, 95% CI 1.51-14.53, P=0.007). Conclusions: For the treatment of high-risk TIA or minor stroke patients, the clopidogrel-aspirin treatment did not increase the number of CMB than Aspirin alone. It appears that the extent of CMB was associated with the extent of existing CMB occurred in previous stroke, which was mostly located in cortical, subcortical zone.

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出版当年[2014]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 神经科学
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 临床神经病学 4 区 神经科学
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出版当年[2013]版:
Q3 CLINICAL NEUROLOGY Q4 NEUROSCIENCES
最新[2023]版:
Q3 CLINICAL NEUROLOGY Q4 NEUROSCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2013版] 出版当年五年平均 出版前一年[2012版] 出版后一年[2014版]

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第一作者机构: [1]First Peoples Hosp Taizhou, Dept Neurol, Zhejing, Peoples R China;
通讯作者:
通讯机构: [1]First Peoples Hosp Taizhou, Dept Neurol, Zhejing, Peoples R China;
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