Abstract TP405: Dual Antiplatelet Therapy Reduced Stroke Risk in High-risk Transient Ischemic Attack Patients Assessed by ABCD3-I Score

Abstract

Introduction: Studies showed dual antiplatelet therapy (DAPT) benefited TIA patients with an ABCD2 score ≥4. The present study aims to investigate whether the ABCD3-I score could be a more appropriate tool for TIA patients’ selection to use DAPT in the real-world experience. Methods: We derived data from the TIA database of the First Affiliated Hospital of Zhengzhou University. The predictive outcome was ischemic stroke at 90-day. Cox proportional hazards regression was used to examine the interaction effect between risk score and antiplatelet treatment. The Kaplan-Meier curves were plotted to present cumulative stroke rates in different risk patients with monotherapy and DAPT. Results: Among 785 patients, the mean (SD) age was 56.95 (12.73) years and 38.3% were female (n =301). A percentage of 36.9% patients used DAPT during hospitalization, and 77 patients (9.8%) had an ischemic stroke at 90-day. The Kaplan-Meier curves showed a significant difference between patients with monotherapy and DAPT in high-risk TIA patients (p= 0.021, Figure 1). After adjustment for confounding factors, DAPT only reduced 90-day stroke risk in high-risk TIA patients assessed by ABCD3-I score (HR= 0.402, 95%CI 0.189-0.859, p= 0.019, Table 1 and 2). Conclusions: High-risk TIA patients assessed by ABCD3-I score received the most pronounced clinical benefit from DAPT in the real-clinical experience.