Antiplatelet therapy in diabetic ischemic stroke patients: associated factors and outcomes

2011 ◽  
Vol 49 (10) ◽  
pp. 605-613
Author(s):  
Y. Hassan ◽  
S.W. Al-Jabi ◽  
N. Abd Aziz ◽  
I. Looi ◽  
S.H. Zyoud
Keyword(s):  
Ischemic Stroke ◽  
Antiplatelet Therapy ◽  
Associated Factors ◽  
Stroke Patients

Abstract WP424: Efficacy Of Antiplatelet Therapy For Secondary Stroke Prevention Following Lacunar Stroke: A Meta-analysis And Pooled Analysis Of Randomized Controlled Trials

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Ashkan Shoamanesh ◽  
Chun Shing Kwok ◽  
Phyo K Myint ◽  
Yoon K Loke ◽  
Hannah Copley ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Antiplatelet Therapy ◽  
Stroke Prevention ◽  
Recurrent Stroke ◽  
Meta Analysis ◽  
Antiplatelet Agents ◽  
Pooled Analysis ◽  
Cochrane Library ◽  
Lacunar Stroke ◽  
Stroke Patients

INTRODUCTION: The predominant underlying mechanism of lacunar stroke differs from that of other ischemic stroke subtypes. Accordingly, so may the ideal stroke prevention regimen. We aimed to evaluate the efficacy of different antiplatelet agents in lacunar stroke patients. Method: We searched MEDLINE, EMBASE and the Cochrane library for RCTs that evaluated antiplatelet therapy in patients with ischemic stroke. Trials which provided stroke recurrence rates in patients presenting with lacunar stroke, or where the data was obtainable from manuscript authors were included. In addition, we included the novel SPS3 trial’s antiplatelet arm data presented at the 2011 ISC. We performed pooled analysis to assess the crude frequency of recurrent stroke and a random effects meta-analysis. Results: Lacunar stroke data was available for 12 trials encompassing 35, 218 participants (mean age 65, 65% male). The pooled crude recurrent stroke rate was least for cilostazol monotherapy (6.2%), followed by ASA monotherapy (7.4%), clopidogrel monotherapy (8.6%), ASA/dipyridamole (8.6%) and greatest for ASA/clopidogrel therapy (9.1%). Rate ratios of lacunar stroke patients suggest no significant efficacy advantage for ASA [ASA vs placebo (RR 0.72, 95% CI 0.34-1.50; p=0.38)], ASA/clopidogrel [ASA/clopidogrel vs ASA (RR 0.80, 95% CI 0.62-1.03; p=0.08), ASA/clopidogrel vs clopidogrel (RR 0.95, 95% CI 0.79-1.15; p=0.63)], sarpogrelate [sarpogrelate vs ASA (RR 1.31, 95% CI 0.84-2.04; p=0.23)] and ASA/dipyridamole [ASA/dipyridamole vs ASA (RR 0.90, 95% CI 0.70-1.16; p=0.042)] for recurrent stroke. The results from Japanese trials evaluating the efficacy of cilostazol found that it is significantly better than both placebo (RR 0.51, 95% CI 0.30-0.85; p=0.01) and ASA (RR 0.70, 95% CI 0.51-0.96; p=0.03) in the secondary prevention of stroke. Conclusions: There seems to be no significant advantage among the various antiplatelet agents studied in lacunar stroke patients apart for cilostazol. However, this requires confirmation within large randomized trials outside of Japanese populations.

Abstract TP136: Dual versus Mono Antiplatelet Therapy in Acute Ischemic Stroke Patients Due to Large Artery Atherosclerosis

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Dohoung Kim ◽  
Jong-Moo Park ◽  
Yong-Jin Cho ◽  
Kyung Bok Lee ◽  
Tai Hwan Park ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Antiplatelet Therapy ◽  
Large Artery ◽  
Stroke Patients ◽  
Dual Versus

scholarly journals Treatment Outcomes and Associated Factors among Hospitalized Stroke Patients at Shashemene Referral Hospital, Ethiopia

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Tegegne Gobezie Temesgen ◽  
Berhanu Teshome ◽  
Peter Njogu
Keyword(s):  
Ischemic Stroke ◽  
Treatment Outcome ◽  
Treatment Outcomes ◽  
Associated Factors ◽  
Common Type ◽  
Referral Hospital ◽  
P Value ◽  
Stroke Patients ◽  
Good Treatment Outcome ◽  
Study Participants

Background. The 2013 Global Burden of Disease report indicated that 80% of stroke deaths occur in low- and middle-income regions. Although stroke has been consistently reported as one of the three leading causes of morbidity and mortality in the past years in Ethiopia, there is a paucity of data regarding treatment outcomes of stroke if sufficient. Hence, the present study aimed to assess patterns of treatment outcomes and associated factors among hospitalized stroke patients at Shashemene Referral Hospital. Methods. A retrospective cross-sectional study was conducted at the medical ward of Shashemene Referral Hospital. A total of 73 hospitalized stroke patients during the period 2012–2017 were included in the study. Demographic characteristics, risk factors, and stroke types and their hospital outcomes were reviewed from the medical records of the patients. The data were entered and analyzed using SPSS version 16.0. Descriptive statistics such as percent and frequency were used to summarize patients’ characteristics. Binary logistic regression was used to investigate the potential predictors of treatment outcome. A p-value ≤0.05 was considered statistically significant. Result. Ischemic stroke was the most common type of stroke (65.8%) diagnosed in our setting. Hypertension (52.05%) was the common comorbid condition. More than half (54.79%) of the stroke patients improved on treatment. Dyslipidemics were prescribed to 68.49% of patients and the most popular antiplatelet was aspirin, which was prescribed to 61.64% of the study participants. Age, sex, type of stroke, and type of comorbidity were not significant factors of stroke treatment outcome. Conclusion. Ischemic stroke was the most common type of stroke diagnosed among the study participants while aspirin and statins were the most frequently used drugs in the management of stroke. Approximately 50% of hospitalized stroke patients had good treatment outcome and none of the investigated variables were significantly associated with the treatment outcomes.

scholarly journals Embolic strokes of undetermined source: Prevalence and patient features in the ESUS Global Registry

2016 ◽  
Vol 11 (5) ◽  
pp. 526-533 ◽  
Author(s):  
Kanjana S Perera ◽  
Thomas Vanassche ◽  
Jackie Bosch ◽  
Mohana Giruparajah ◽  
Balakumar Swaminathan ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Antiplatelet Therapy ◽  
Secondary Stroke Prevention ◽  
Stroke Patients ◽  
Diagnostic Investigation ◽  
Cross Sectional ◽  
Stroke Research ◽  
The Mean ◽  
Global Registry ◽  
Prior Stroke

Background Recent evidence supports that most non-lacunar cryptogenic strokes are embolic. Accordingly, these strokes have been designated as embolic strokes of undetermined source (ESUS). Aims We undertook an international survey to characterize the frequency and clinical features of ESUS patients across global regions. Methods Consecutive patients hospitalized for ischemic stroke were retrospectively surveyed from 19 stroke research centers in 19 different countries to collect patients meeting criteria for ESUS. Results Of 2144 patients with recent ischemic stroke, 351 (16%, 95% CI 15% to 18%) met ESUS criteria, similar across global regions (range 16% to 21%), and an additional 308 (14%) patients had incomplete evaluation required for ESUS diagnosis. The mean age of ESUS patients (62 years; SD = 15) was significantly lower than the 1793 non-ESUS ischemic stroke patients (68 years, p ≤ 0.001). Excluding patients with atrial fibrillation ( n = 590, mean age = 75 years), the mean age of the remaining 1203 non-ESUS ischemic stroke patients was 64 years ( p = 0.02 vs. ESUS patients). Among ESUS patients, hypertension, diabetes, and prior stroke were present in 64%, 25%, and 17%, respectively. Median NIHSS score was 4 (interquartile range 2–8). At discharge, 90% of ESUS patients received antiplatelet therapy and 7% received anticoagulation. Conclusions This cross-sectional global sample of patients with recent ischemic stroke shows that one-sixth met criteria for ESUS, with additional ESUS patients likely among those with incomplete diagnostic investigation. ESUS patients were relatively young with mild strokes. Antiplatelet therapy was the standard antithrombotic therapy for secondary stroke prevention in all global regions.

scholarly journals Impact of Diabetes on Platelet Function in Acute Ischemic Stroke Patients Taking Dual Antiplatelet Therapy

2021 ◽  
Vol 12 ◽  
Author(s):  
Yinping Guo ◽  
Yi Zhang ◽  
Jing Zhao ◽  
Lingshan Wu ◽  
Zhiyuan Yu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Antiplatelet Therapy ◽  
Platelet Function ◽  
Dual Antiplatelet Therapy ◽  
Platelet Reactivity ◽  
Significant Risk ◽  
Maximum Amplitude ◽  
Stroke Patients ◽  
Clot Strength

Objectives: Diabetes mellitus (DM) is a significant risk factor for ischemic stroke and associated with platelet reactivity. We aim to evaluate the effect of DM on platelet function in acute ischemic stroke patients taking dual antiplatelet therapy (DAPT).Methods: We consecutively included patients with acute ischemic stroke taking DAPT. Platelet function was assessed by thromboelastography and the arachidonic acid (AA) or adenosine diphosphate (ADP) induced platelet inhibition rate were used to confirmed the high-residual on-treatment platelet reactivity (HRPR) to aspirin or clopidogrel. We classified patients into DM and non-DM groups. The association between DM and platelet function was assessed and the confounding factors were adjusted by propensity score matching (PSM) analysis. The independent risk factors of HRPR were determined by multivariate logistic regression analysis.Results: A total of 1,071 acute ischemic stroke patients, 712 in the non-DM group and 359 in the DM group, were included. Patients with DM had a significantly higher maximum amplitude (63.0 vs. 62.0 mm, P < 0.01), ADP-induced clot strength (34.6 vs. 30.3 mm, P < 0.01) and clopidogrel HRPR rate (22.6% vs. 17.3%, P = 0.038) than those without DM. Among 662 patients after PSM, the maximum amplitude (63.1 vs. 62.5 mm, P = 0.032), ADP-induced clot strength (34.6 vs. 29.3 mm, P < 0.01) and clopidogrel HRPR rate (23.0% vs. 15.7%, P = 0.018) is still higher in the DM group. DM was an independent factor of clopidogrel HRPR (OR = 1.48, 95% CI: 1.03–2.07, P < 0.05).Conclusions: In acute ischemic stroke patients taking DAPT, DM is associated with increased platelet reactivity and higher prevalence of clopidogrel HRPR.

Sign in / Sign up

Export Citation Format

Share Document