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Trends in Dual Antiplatelet Therapy of Aspirin and Clopidogrel and Outcomes in Ischemic Stroke Patients Noneligible for POINT/CHANCE Trial Treatment
DC Field | Value | Language |
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dc.contributor.author | Kim, Joon-Tae | - |
dc.contributor.author | Lee, Ji Sung | - |
dc.contributor.author | Kim, Hyunsoo | - |
dc.contributor.author | Kim, Beom Joon | - |
dc.contributor.author | Lee, Keon-Joo | - |
dc.contributor.author | Park, Jong-Moo | - |
dc.contributor.author | Kang, Kyusik | - |
dc.contributor.author | Lee, Soo Joo | - |
dc.contributor.author | Kim, Jae Guk | - |
dc.contributor.author | Cha, Jae-Kwan | - |
dc.contributor.author | Kim, Dae-Hyun | - |
dc.contributor.author | Park, Tai Hwan | - |
dc.contributor.author | Lee, Kyungbok | - |
dc.contributor.author | Lee, Jun | - |
dc.contributor.author | Hong, Keun-Sik | - |
dc.contributor.author | Cho, Yong-Jin | - |
dc.contributor.author | Park, Hong-Kyun | - |
dc.contributor.author | Lee, Byung-Chul | - |
dc.contributor.author | Yu, Kyung-Ho | - |
dc.contributor.author | Oh, Mi Sun | - |
dc.contributor.author | Kim, Dong-Eog | - |
dc.contributor.author | Choi, Jay Chol | - |
dc.contributor.author | Kwon, Jee-Hyun | - |
dc.contributor.author | Kim, Wook-Joo | - |
dc.contributor.author | Shin, Dong-Ick | - |
dc.contributor.author | Yum, Kyu Sun | - |
dc.contributor.author | Sohn, Sung Il | - |
dc.contributor.author | Hong, Jeong-Ho | - |
dc.contributor.author | Lee, Sang-Hwa | - |
dc.contributor.author | Park, Man-Seok | - |
dc.contributor.author | Ryu, Wi-Sun | - |
dc.contributor.author | Park, Kwang-Yeol | - |
dc.contributor.author | Lee, Juneyoung | - |
dc.contributor.author | Saver, Jeffrey L. | - |
dc.contributor.author | Bae, Hee-Joon | - |
dc.date.accessioned | 2024-08-08T01:19:31Z | - |
dc.date.available | 2024-08-08T01:19:31Z | - |
dc.date.created | 2024-06-05 | - |
dc.date.created | 2024-06-05 | - |
dc.date.issued | 2024-05 | - |
dc.identifier.citation | Journal of the American Heart Association, Vol.13 No.10, p. e033611 | - |
dc.identifier.issn | 2047-9980 | - |
dc.identifier.uri | https://hdl.handle.net/10371/205064 | - |
dc.description.abstract | BACKGROUND: Recent clinical trials established the benefit of dual antiplatelet therapy with aspirin and clopidogrel (DAPT-AC) in early-presenting patients with minor ischemic stroke. However, the impact of these trials over time on the use and outcomes of DAPT-AC among the patients with nonminor or late-presenting stroke who do not meet the eligibility criteria of these trials has not been delineated. METHODS AND RESULTS: In a multicenter stroke registry, this study examined yearly changes from April 2008 to August 2022 in DAPT-AC use for stroke patients ineligible for CHANCE/POINT (Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events/Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke) clinical trials due to National Institutes of Health Stroke Scale >4 or late arrival beyond 24 hours of onset. A total of 32 118 patients (age, 68.1±13.1 years; male, 58.5%) with National Institutes of Health Stroke Scale of 4 (interquartile range, 1-7) were analyzed. In 2008, DAPT-AC was used in 33.0%, other antiplatelets in 62.7%, and no antiplatelet in 4.3%. The frequency of DAPT-AC was relatively unchanged through 2013, when the CHANCE trial was published, and then increased steadily, reaching 78% in 2022, while other antiplatelets decreased to 17.8% in 2022 (Ptrend<0.001). From 2011 to 2022, clinical outcomes nonsignificantly improved, with an average relative risk reduction of 2%/y for the composite of stroke, myocardial infarction, and all-cause mortality, both among patients treated with DAPT-AC and patients treated with other antiplatelets. CONCLUSIONS: Use of DAPT-AC in stroke patients with stroke ineligible for recent DAPT clinical trials increased markedly and steadily after CHANCE publication in 2013, reaching deployment in nearly 4 of every 5 patients by 2022. The secondary prevention in patients with ischemic stroke seems to be gradually improving, possibly due to the enhancement of risk factor control. | - |
dc.language | 영어 | - |
dc.publisher | Wiley-Blackwell | - |
dc.title | Trends in Dual Antiplatelet Therapy of Aspirin and Clopidogrel and Outcomes in Ischemic Stroke Patients Noneligible for POINT/CHANCE Trial Treatment | - |
dc.type | Article | - |
dc.identifier.doi | 10.1161/JAHA.123.033611 | - |
dc.citation.journaltitle | Journal of the American Heart Association | - |
dc.identifier.wosid | 001228221200015 | - |
dc.identifier.scopusid | 2-s2.0-85194013757 | - |
dc.citation.number | 10 | - |
dc.citation.startpage | e033611 | - |
dc.citation.volume | 13 | - |
dc.description.isOpenAccess | N | - |
dc.contributor.affiliatedAuthor | Bae, Hee-Joon | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.subject.keywordAuthor | acute ischemic stroke | - |
dc.subject.keywordAuthor | aspirin | - |
dc.subject.keywordAuthor | clopidogrel | - |
dc.subject.keywordAuthor | dual antiplatelet treatment | - |
dc.subject.keywordAuthor | late‐presenting stroke | - |
dc.subject.keywordAuthor | nonminor stroke | - |
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