The relationship between antiplatelet therapies and the outcome of endovascular treatment for acute ischemic stroke

Abstract

PurposeWe conducted this study to investigate the safety and efficacy of antiplatelet therapies (APT) for acute ischemic patients received endovascular treatment (EVT). MethodsThe population of our study was derived from a nationwide multicentered registry conducted by 111 centers in China. Patients were divided to groups of no APT, single APT (SAPT) or dual APT (DAPT) according to the APT received at 24 h after EVT. The primary outcome was 90-day functional independence, and the safety outcomes included the symptomatic intracranial hemorrhage (sICH), any type of intracranial hemorrhage, and all-caused death within 90 days. Patient characteristics, procedural data, and outcomes were analyzed. ResultsA total of 1679 patients were included in this study, 71.42% of whom received oral APT at 24 h after EVT, and the initial time was 20.53(13.94–27.17) hours after recanalization or the end of procedure. 90-day functional independence was significantly more observed in patients with DAPT (54.02% vs. 33.64%; adjusted odds ratio [OR] 1.940, 95% CI 1.444–2.606), but not in SAPT (40.75% vs. 33.64%; adjusted OR 1.280, 95% CI 0.907–1.804) compared with patients without APT. APT increased the risk of sICH (1.14% vs. 0, p = 0.036). Both the application of DAPT (adjusted OR 0.264, 95% CI 0.178–0.392, p < 0.001) and SAPT (adjusted OR 0.341, 95% CI 0.213–0.545, p < 0.001) could reduce the 90-day mortality. ConclusionsIn this uncontrolled series of patients APT at 24 h after EVT showed improvement of the patients' functional independence and reduction of mortality, even though the rate of sICH was increased, especially in the DAPT-group.