Dual anti-platelet aggregation Versus Aspirin alone in acute minor ischemic stroke and high-risk TIA: A Tunisian Study (S20.006)

Abstract

<h3>Objective:</h3> The aim of our work was to study the role of DAAP, in comparison with aspirin alone, in improving motor deficit and in preventing ischemic recurrence, while taking into account the possible hemorrhagic risk. <h3>Background:</h3> Even though the benefit of aspirin is well known to prevent recurrence of thrombotic events after any transient ischemic attack (TIA) or ischemic stroke, the role of dual anti-platelet aggregation (DAAP) is not definitively established and remains a controversial subject. <h3>Design/Methods:</h3> We conducted a retrospective review study in the Neurology Department at the Fattouma Bourguiba University Hospital of Monastir over a four-year period, from January 1, 2018 to February 18, 2022. We compared two groups of patients, of which one group had the DAAP (as in the CHANCE study) and one group received aspirin alone. We compared the initial NIHSS score, at discharge, at 1, 3, 6 months and 1 year, the risk of reocurrence, the risk of bleeding and vascular death. <h3>Results:</h3> 408 patients were included in this study. The mean age was 62.49 years (≥ 40) and 64,2% were males. DAAP was administered in 111 patients (27.2%), among them 17.1% received the initial doses of 300mg of Clopidogrel. Compared to non-DAAP group: 279 (72.8%). The median time from the onset of the admission was 18,8 hours. NIHSS score at discharge was ≤ 2 in 60,2% in the DAAP group vs 38% of patients in the non-DAAP group (p=0,034). Ischemic recurrence occurred in 3% of patients in the clopidogrel-aspirin group and in 4% in the aspirin alone group (p=0,04). There was no significant difference about the occurrence of any bleeding event (0,9% vs 2,6% p=0,173) nor Vascular Death. <h3>Conclusions:</h3> Our results are consistent with those of the literature about the superiority of dual anti-platelet aggregation (DAAP) in minor strokes. <b>Disclosure:</b> Miss Saad has nothing to disclose. Mariem Mhiri has nothing to disclose. Dr. Ben Dhia has nothing to disclose. Ms. Abbes has nothing to disclose. Dr. Gouta has nothing to disclose. Mouna Aissi has nothing to disclose. MAHBOUBA FRIH has nothing to disclose.