Comparative effectiveness of dual to single antiplatelet therapy after one year versus seven years in patients with acute ischemic stroke combined with cerebral microbleeds

Abstract

BackgroundCerebral microbleeds (CMBs) were thought to be associated with stroke. The relationship CMBs, antiplatelet therapy and prognosis is still unclear. Our aim here was to compare the long-term risk of stoke between dual and single antiplatelet therapies in patients of acute ischemic stroke (IS) combined with CMBs. MethodWe conducted a retrospective cohort study of 1017 acute IS patients received susceptibility weighted imaging (SWI) magnetic resonance imaging (MRI) sequences. We constructed a sample of patients received short-term dual antiplatelet therapy (DAPT) (n = 154) and received single antiplatelet therapy (SAPT) (n = 125), followed them for up to 7 years (median 33 months). DAPT was prescribed for at least 3 weeks, followed by using SAPT. The primary endpoint was a composite of all-cause death, recurrence IS or intracerebral hemorrhage (ICH). Secondary endpoints were a composite of recurrent IS or ICH, and the recurrent IS. ResultAt last follow-up, rated of the endpoints were similar in patients treated with SAPT and DAPT (P > 0.05). The IS risk was higher in patients treated with SAPT in the first year after the occurrence of acute IS (P = 0.035). And in 0–1 year or in 1–7 year, the risk of primary endpoint and main secondary endpoint were similar among patients treated with SAPT and DAPT (P > 0.05). ConclusionThe study is limited due to different baseline characteristics. We initially consider that the short-term DAPT may be considered to potentially reduce the rate of recurrent IS in the first year. In patients of IS combined with CMBs, the short-term DAPT may be recommended to reduce the recurrent IS.