Effect of prestroke antiplatelets use on first-ever ischaemic stroke severity and early outcome

Bembenek, Jan; Niewada, Maciej; Karliñski, Michał; Członkowska, Anna

doi:10.1111/ijcp.12804

Cited by 6 publications

(3 citation statements)

References 24 publications

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“…In conclusion, our findings point at a potential effect of antiplatelet usage upon clot composition within the intracranial artery. This could explain previously observed favorable effects of antiplatelets on stroke severity and varying success of recanalization efforts [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 73%

Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke

Pikija

Magdič

Lukić

et al. 2016

IJMS

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We explored whether clot density in middle cerebral artery (MCA) occlusion is related to clinical variables, stroke etiology, blood constituents, and prestroke medication. We performed a retrospective chart review of patients with acute ischemic stroke of the anterior circulation admitted to two Central European stroke centers. The acquisition of non-contrast enhanced CT (NECT) and CT angiography (CTA) within 4.5 h of symptom onset was obligatory. We assessed the site of MCA occlusion as well as density, area, and length of the clot in 150 patients. The Hounsfield unit values for the clot were divided with contralateral MCA segment to yield relative Hounsfield Unit ratio (rHU). The site of the vessel occlusion (M1 vs. M2) and antiplatelet usage, but not stroke etiology, significantly influenced rHU. We found an inverse correlation of rHU with erythrocyte count (p < 0.001). The multivariate analysis revealed that a higher rHU (i.e., clot being more hyperdense) was more likely with the use of antiplatelets (OR 4.24, CI 1.10–16.31, p = 0.036). Erythrocyte (OR 0.18, CI 0.05–0.55, p = 0.003), and thrombocyte counts (OR 0.99, CI 0.98–0.99, p = 0.029) were associated with odds for more hypodense clots (lower rHU). Our study disclosed that antiplatelet therapy impacts the composition of intracranial clots of the anterior circulation.

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Section: Discussionmentioning

confidence: 73%

Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke

Pikija

Magdič

Lukić

et al. 2016

IJMS

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“…To overcome an imbalance of clinical background between those with and without antiplatelet treatment, some researchers have used multivariate analysis [2,13,23], particularly in using propensity score matching [3,12]. Again, there has been no previous study that targeted patients with a prior history of stroke, i.e., secondary stroke prevention.…”

Section: Discussionmentioning

confidence: 99%

“…Antiplatelet agents have well-established effectiveness in the secondary prevention of ischemic stroke, and there is evidence that prior antiplatelet use is associated with a reduction of stroke severity in patients with rst-ever ischemic stroke [1][2][3]. It has been controversial, however, as to whether preceding treatment with antiplatelet agents reduces the severity of recurrent ischemic stroke [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Effect of preceding antiplatelet agents on ischemic stroke severity in patients with a history of stroke

Yamada

Tanaka

Kishitani

et al. 2022

Preprint

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Background: Antiplatelet agents are effective in secondary prevention of ischemic stroke and can reduce the severity of first-ever ischemic stroke. However, it remains controversial whether prophylactic administration of antiplatelet agents can reduce the severity of recurrent ischemic stroke. This study aimed to determine the effect of preceding antiplatelet treatment on ischemic stroke severity in patients with a prior history of stroke.Methods: From the prospective hospital registry of 1338 consecutive patients with ischemic stroke within 7 days of symptom onset, we identified patients with a prior history of stroke who were admitted due to cerebral thrombosis, which included large-artery atherosclerosis, small vessel occlusion, and branch atheromatous disease. Patients were categorized into 2 groups according to preceding medication: antiplatelet (AP) group and none (N) group. Those with preceding anticoagulant agents or unknown prior medication were excluded. Stroke severity (National Institutes of Health Stroke Scale: NIHSS) on admission was compared between the 2 groups.Results: A total of 88 patients were analyzed. Out of these, 66 were identified in the AP group (median age 78, male 71%), and 22 in the N group (median age 71, male 73%). The median NIHSS on admission was lower in the AP group than in the N group (3 vs 5, p=0.043). In multivariate analysis, preceding antiplatelet treatment was independently associated with mild stroke (NIHSS ≤4) on admission (odds ratio 5.77, 95% confidence interval 1.73-21.6, p=0.004).Conclusion: Preceding antiplatelet treatment in patients with a prior history of stroke may reduce the severity of subsequent cerebral thrombosis.

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Association between pre-stroke physical fitness and global and motor outcomes after ischemic stroke

Fornazzari,

Sousa,

Okuno

et al. 2023

Sport Sci Health

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Effect of prestroke antiplatelets use on first-ever ischaemic stroke severity and early outcome

Abstract: Our findings provide further evidence supporting modest benefit of AP therapy on the course and outcome of first-ever ischaemic stroke. Further large studies are needed to confirm this effect.

Cited by 6 publications

References 24 publications

Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke

Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke

Effect of preceding antiplatelet agents on ischemic stroke severity in patients with a history of stroke

Association between pre-stroke physical fitness and global and motor outcomes after ischemic stroke

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