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Prestroke antiplatelet agents in first-ever ischemic stroke Clinical effects

Title
Prestroke antiplatelet agents in first-ever ischemic stroke Clinical effects
Author
최정순
Keywords
TREATMENT TOAST; SEVERITY; ASPIRIN; TRIAL; OUTCOMES; ASSOCIATION; STATINS; DISEASE; CLASSIFICATION; TOLERANCE
Issue Date
2015-03
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
NEUROLOGY, v. 84, NO 11, Page. 1080-1089
Abstract
Objective:To investigate whether prestroke antiplatelet agent (PA) use was associated with initial stroke severity.Methods:This was a retrospective, case-control study based on data from a prospectively collected hospital-based stroke registry (Korea University Stroke Registry). A total of 3,025 patients who were admitted with a diagnosis of first-ever ischemic stroke within 5 days of symptom onset were included. Stroke severity was measured with the NIH Stroke Scale (NIHSS). NIHSS score 4 at admission was categorized as mild stroke. Patients from the PA group were matched with those from the non-PA group using estimated propensity scores at a 1:1 ratio. Stepwise multivariable logistic regression analyses were performed on patients in the matched datasets with initial mild stroke.Results:Patients' mean age was 66.3 13.0 years, and 1,850 were men (61.5%). A total of 748 patients had been taking antiplatelet agents prior to stroke onset; 644 patients (86.1%) were taking a single antiplatelet agent. Among these agents, aspirin (83.7%) was the most common. A total of 102 patients (13.6%) were taking 2 antiplatelet agents. Multivariable analysis after propensity score matching demonstrated that PA use was associated with initial mild stroke (odds ratio 1.344; 95% confidence interval 1.014-1.782).Conclusions:PA use was associated with decreased first-ever stroke severity, suggesting that it has a beneficial effect.Classification of evidence:This study provides Class II evidence that prestroke use of antiplatelet agents reduces stroke severity in patients with first-ever acute ischemic stroke.
URI
http://www.neurology.org/content/84/11/1080.shorthttp://hdl.handle.net/20.500.11754/22805
ISSN
0028-3878; 1526-632X
DOI
10.1212/WNL.0000000000001361
Appears in Collections:
COLLEGE OF NATURAL SCIENCES[S](자연과학대학) > MATHEMATICS(수학과) > Articles
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