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Abstract
Dual antiplatelet therapy (DAPT) reduced stroke risk in high-risk transient ischemic attack (TIA) patients assessed by ABCD2 score. Patients with positive diffusion-weighted imaging (DWI) were identified as imaging-based high-risk. The present study aims to investigate whether DAPT could reduce stroke risk in TIA with DWI positive. The study enrolled TIA patients within 72 h of onset from the prospective TIA database of the First Affiliated Hospital of Zhengzhou University. The predictive outcome was ischemic stroke at 90-day. The relationship between DAPT and stroke was analyzed in a cox proportional hazards model. The Kaplan–Meier curves of TIA patients with DAPT and monotherapy were plotted. Total of 661 TIA patients were enrolled, 279 of whom were DWI positive and 281 used DAPT. The 90-day stroke risk was higher in patients used monotherapy than those used DAPT in TIA with positive DWI (23.7% vs. 13.4%, p = 0.029). DAPT was associated with reduced stroke risk in TIA patients with positive DWI (hazard ratio [HR] = 0.54; 95% confidence interval [CI], 0.30–0.97; p = 0.037). However, the benefit didn’t exist in TIA patients with negative DWI (HR = 0.43; 95% CI, 0.14–1.33; p = 0.142). Early use of DAPT reduced stroke risk in TIA patients with positive DWI.
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Details
1 the First Affiliated Hospital of Zhengzhou University At Zhengzhou, Department of Neurology, Henan Key Laboratory of Cerebrovascular Disease, Zhengzhou, China (GRID:grid.412633.1)
2 Massachusetts General Hospital and Harvard Medical School, Departments of Radiology and Neurology, Boston, USA (GRID:grid.32224.35) (ISNI:0000 0004 0386 9924)
3 Massachusetts General Hospital, Harvard Medical School, Department of Neurology, Clinical Proteomics Research Center and Cardio-Neurology Clinic, Boston, USA (GRID:grid.32224.35) (ISNI:0000 0004 0386 9924)