Discussion on the application of ABCD3-I score in preventing and treating transient ischemic attack

Abstract

Objective To evaluate the efficacy and safety of aspirin monotherapy and aspirin combining with clopidogrel therapy in treating transient ischemic attack (TIA) according to different risk stratification. Methods A total of 122 TIA patients was divided into 2 groups: single resistance group (treated only by aspirin) and dual anti-platelet aggregation group (treated with aspirin and clopidogrel). According to Age, Blood pressure, Clinical features, Duration, and Diabetes plus Dual TIA (ABCD3-Ⅰ) score, they were further divided into low-risk, middle-risk and high-risk groups. The incidences of ischemic stroke and adverse events in each group were evaluated. Results After 3-week treatment, the incidence of ischemic stroke in low-risk groups was both 0, while it was 9/20 in middle-risk single resistance group, 2/19 in middle-risk dual anti-platelet aggregation group, 10/19 in high-risk single resistance group, and 3/20 in high-risk dual anti-platelet aggregation group. The differences among those groups were statistically significant ( P = 0.031, 0.019). The most common drug adverse reactions were nausea and acid regurgitation ( χ 2 = 0.000, P = 1.000). No obvious bleeding tendency or liver and kidney dysfunction was found. Conclusions ABCD3-Ⅰ score may be used as the safety evaluation index of anti-platelet drugs. The application of aspirin combining with clopidogrel may have an advantage over aspirin monotherapy in the prevention of ischemic stroke. DOI: 10.3969/j.issn.1672-6731.2015.01.011