Different antiplatelet strategies in patients with new ischemic stroke while taking aspirin

Joon Tae Kim, Man Seok Park, Kang Ho Choi, Ki Hyun Cho, Beom Joon Kim, Moon Ku Han, Tai Hwan Park, Sang Soon Park, Kyung Bok Lee, Byung Chul Lee, Kyung Ho Yu, Mi Sun Oh, Jae Kwan Cha, Dae Hyun Kim, Hyun Wook Nah, Jun Lee, Soo Joo Lee, Young Chai Ko, Jae Guk Kim, Jong Moo Park & 13 others Kyusik Kang, Yong Jin Cho, Keun Sik Hong, Jay Chol Choi, Dong Eog Kim, Wi Sun Ryu, Dong Ick Shin, Min Ju Yeo, Wook Joo Kim, Juneyoung Lee, Ji Sung Lee, Jeffrey L. Saver, Hee Joon Bae

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background and Purpose - Selecting among different antiplatelet strategies when patients experience a new ischemic stroke while taking aspirin is a common clinical challenge, currently addressed by a paucity of data. Methods - This study is an analysis of a prospective multicenter stroke registry database from 14 hospitals in South Korea. Patients with acute noncardioembolic stroke, who were taking aspirin for prevention of ischemic events at the time of onset of stroke, were enrolled. Study subjects were divided into 3 groups according to the subsequent antiplatelet therapy strategy pursued; maintaining aspirin monotherapy (MA group), switching aspirin to nonaspirin antiplatelet agents (SA group), and adding another antiplatelet agent to aspirin (AA group). The primary study end point was the composite of stroke (ischemic and hemorrhagic), myocardial infarction, and vascular death up to 1 year after stroke onset. Results - A total of 1172 patients were analyzed for this study. Antiplatelet strategies pursued in study patients were MA group in 212 (18.1%), SA group in 246 (21.0%), and AA group in 714 (60.9%). The Cox proportional hazards regression analysis showed that, compared with the MA group, there was a reduction in the composite vascular event primary end point in the SA group (hazard ratio, 0.50; 95% confidence interval, 0.27-0.92; P=0.03) and in the AA group (hazard ratio, 0.40; 95% confidence interval, 0.24-0.66; P<0.001). Conclusions - This study showed that, compared with maintaining aspirin, switching to or adding alternative antiplatelet agents may be better in preventing subsequent vascular events in patients who experienced a new ischemic stroke while taking aspirin.

Original languageEnglish
Pages (from-to)128-134
Number of pages7
JournalStroke
Volume47
Issue number1
DOIs
Publication statusPublished - 2016 Jan 1

Fingerprint

Aspirin
Stroke
Platelet Aggregation Inhibitors
Blood Vessels
Confidence Intervals
Republic of Korea
Registries
Myocardial Infarction
Regression Analysis
Databases

Keywords

  • antiplatelet agents
  • aspirin
  • multicenter studies
  • stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Kim, J. T., Park, M. S., Choi, K. H., Cho, K. H., Kim, B. J., Han, M. K., ... Bae, H. J. (2016). Different antiplatelet strategies in patients with new ischemic stroke while taking aspirin. Stroke, 47(1), 128-134. https://doi.org/10.1161/STROKEAHA.115.011595

Different antiplatelet strategies in patients with new ischemic stroke while taking aspirin. / Kim, Joon Tae; Park, Man Seok; Choi, Kang Ho; Cho, Ki Hyun; Kim, Beom Joon; Han, Moon Ku; Park, Tai Hwan; Park, Sang Soon; Lee, Kyung Bok; Lee, Byung Chul; Yu, Kyung Ho; Oh, Mi Sun; Cha, Jae Kwan; Kim, Dae Hyun; Nah, Hyun Wook; Lee, Jun; Lee, Soo Joo; Ko, Young Chai; Kim, Jae Guk; Park, Jong Moo; Kang, Kyusik; Cho, Yong Jin; Hong, Keun Sik; Choi, Jay Chol; Kim, Dong Eog; Ryu, Wi Sun; Shin, Dong Ick; Yeo, Min Ju; Kim, Wook Joo; Lee, Juneyoung; Lee, Ji Sung; Saver, Jeffrey L.; Bae, Hee Joon.

In: Stroke, Vol. 47, No. 1, 01.01.2016, p. 128-134.

Research output: Contribution to journalArticle

Kim, JT, Park, MS, Choi, KH, Cho, KH, Kim, BJ, Han, MK, Park, TH, Park, SS, Lee, KB, Lee, BC, Yu, KH, Oh, MS, Cha, JK, Kim, DH, Nah, HW, Lee, J, Lee, SJ, Ko, YC, Kim, JG, Park, JM, Kang, K, Cho, YJ, Hong, KS, Choi, JC, Kim, DE, Ryu, WS, Shin, DI, Yeo, MJ, Kim, WJ, Lee, J, Lee, JS, Saver, JL & Bae, HJ 2016, 'Different antiplatelet strategies in patients with new ischemic stroke while taking aspirin', Stroke, vol. 47, no. 1, pp. 128-134. https://doi.org/10.1161/STROKEAHA.115.011595
Kim, Joon Tae ; Park, Man Seok ; Choi, Kang Ho ; Cho, Ki Hyun ; Kim, Beom Joon ; Han, Moon Ku ; Park, Tai Hwan ; Park, Sang Soon ; Lee, Kyung Bok ; Lee, Byung Chul ; Yu, Kyung Ho ; Oh, Mi Sun ; Cha, Jae Kwan ; Kim, Dae Hyun ; Nah, Hyun Wook ; Lee, Jun ; Lee, Soo Joo ; Ko, Young Chai ; Kim, Jae Guk ; Park, Jong Moo ; Kang, Kyusik ; Cho, Yong Jin ; Hong, Keun Sik ; Choi, Jay Chol ; Kim, Dong Eog ; Ryu, Wi Sun ; Shin, Dong Ick ; Yeo, Min Ju ; Kim, Wook Joo ; Lee, Juneyoung ; Lee, Ji Sung ; Saver, Jeffrey L. ; Bae, Hee Joon. / Different antiplatelet strategies in patients with new ischemic stroke while taking aspirin. In: Stroke. 2016 ; Vol. 47, No. 1. pp. 128-134.
@article{11753f96e09b49679ce40910e15fbd56,
title = "Different antiplatelet strategies in patients with new ischemic stroke while taking aspirin",
abstract = "Background and Purpose - Selecting among different antiplatelet strategies when patients experience a new ischemic stroke while taking aspirin is a common clinical challenge, currently addressed by a paucity of data. Methods - This study is an analysis of a prospective multicenter stroke registry database from 14 hospitals in South Korea. Patients with acute noncardioembolic stroke, who were taking aspirin for prevention of ischemic events at the time of onset of stroke, were enrolled. Study subjects were divided into 3 groups according to the subsequent antiplatelet therapy strategy pursued; maintaining aspirin monotherapy (MA group), switching aspirin to nonaspirin antiplatelet agents (SA group), and adding another antiplatelet agent to aspirin (AA group). The primary study end point was the composite of stroke (ischemic and hemorrhagic), myocardial infarction, and vascular death up to 1 year after stroke onset. Results - A total of 1172 patients were analyzed for this study. Antiplatelet strategies pursued in study patients were MA group in 212 (18.1{\%}), SA group in 246 (21.0{\%}), and AA group in 714 (60.9{\%}). The Cox proportional hazards regression analysis showed that, compared with the MA group, there was a reduction in the composite vascular event primary end point in the SA group (hazard ratio, 0.50; 95{\%} confidence interval, 0.27-0.92; P=0.03) and in the AA group (hazard ratio, 0.40; 95{\%} confidence interval, 0.24-0.66; P<0.001). Conclusions - This study showed that, compared with maintaining aspirin, switching to or adding alternative antiplatelet agents may be better in preventing subsequent vascular events in patients who experienced a new ischemic stroke while taking aspirin.",
keywords = "antiplatelet agents, aspirin, multicenter studies, stroke",
author = "Kim, {Joon Tae} and Park, {Man Seok} and Choi, {Kang Ho} and Cho, {Ki Hyun} and Kim, {Beom Joon} and Han, {Moon Ku} and Park, {Tai Hwan} and Park, {Sang Soon} and Lee, {Kyung Bok} and Lee, {Byung Chul} and Yu, {Kyung Ho} and Oh, {Mi Sun} and Cha, {Jae Kwan} and Kim, {Dae Hyun} and Nah, {Hyun Wook} and Jun Lee and Lee, {Soo Joo} and Ko, {Young Chai} and Kim, {Jae Guk} and Park, {Jong Moo} and Kyusik Kang and Cho, {Yong Jin} and Hong, {Keun Sik} and Choi, {Jay Chol} and Kim, {Dong Eog} and Ryu, {Wi Sun} and Shin, {Dong Ick} and Yeo, {Min Ju} and Kim, {Wook Joo} and Juneyoung Lee and Lee, {Ji Sung} and Saver, {Jeffrey L.} and Bae, {Hee Joon}",
year = "2016",
month = "1",
day = "1",
doi = "10.1161/STROKEAHA.115.011595",
language = "English",
volume = "47",
pages = "128--134",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Different antiplatelet strategies in patients with new ischemic stroke while taking aspirin

AU - Kim, Joon Tae

AU - Park, Man Seok

AU - Choi, Kang Ho

AU - Cho, Ki Hyun

AU - Kim, Beom Joon

AU - Han, Moon Ku

AU - Park, Tai Hwan

AU - Park, Sang Soon

AU - Lee, Kyung Bok

AU - Lee, Byung Chul

AU - Yu, Kyung Ho

AU - Oh, Mi Sun

AU - Cha, Jae Kwan

AU - Kim, Dae Hyun

AU - Nah, Hyun Wook

AU - Lee, Jun

AU - Lee, Soo Joo

AU - Ko, Young Chai

AU - Kim, Jae Guk

AU - Park, Jong Moo

AU - Kang, Kyusik

AU - Cho, Yong Jin

AU - Hong, Keun Sik

AU - Choi, Jay Chol

AU - Kim, Dong Eog

AU - Ryu, Wi Sun

AU - Shin, Dong Ick

AU - Yeo, Min Ju

AU - Kim, Wook Joo

AU - Lee, Juneyoung

AU - Lee, Ji Sung

AU - Saver, Jeffrey L.

AU - Bae, Hee Joon

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Background and Purpose - Selecting among different antiplatelet strategies when patients experience a new ischemic stroke while taking aspirin is a common clinical challenge, currently addressed by a paucity of data. Methods - This study is an analysis of a prospective multicenter stroke registry database from 14 hospitals in South Korea. Patients with acute noncardioembolic stroke, who were taking aspirin for prevention of ischemic events at the time of onset of stroke, were enrolled. Study subjects were divided into 3 groups according to the subsequent antiplatelet therapy strategy pursued; maintaining aspirin monotherapy (MA group), switching aspirin to nonaspirin antiplatelet agents (SA group), and adding another antiplatelet agent to aspirin (AA group). The primary study end point was the composite of stroke (ischemic and hemorrhagic), myocardial infarction, and vascular death up to 1 year after stroke onset. Results - A total of 1172 patients were analyzed for this study. Antiplatelet strategies pursued in study patients were MA group in 212 (18.1%), SA group in 246 (21.0%), and AA group in 714 (60.9%). The Cox proportional hazards regression analysis showed that, compared with the MA group, there was a reduction in the composite vascular event primary end point in the SA group (hazard ratio, 0.50; 95% confidence interval, 0.27-0.92; P=0.03) and in the AA group (hazard ratio, 0.40; 95% confidence interval, 0.24-0.66; P<0.001). Conclusions - This study showed that, compared with maintaining aspirin, switching to or adding alternative antiplatelet agents may be better in preventing subsequent vascular events in patients who experienced a new ischemic stroke while taking aspirin.

AB - Background and Purpose - Selecting among different antiplatelet strategies when patients experience a new ischemic stroke while taking aspirin is a common clinical challenge, currently addressed by a paucity of data. Methods - This study is an analysis of a prospective multicenter stroke registry database from 14 hospitals in South Korea. Patients with acute noncardioembolic stroke, who were taking aspirin for prevention of ischemic events at the time of onset of stroke, were enrolled. Study subjects were divided into 3 groups according to the subsequent antiplatelet therapy strategy pursued; maintaining aspirin monotherapy (MA group), switching aspirin to nonaspirin antiplatelet agents (SA group), and adding another antiplatelet agent to aspirin (AA group). The primary study end point was the composite of stroke (ischemic and hemorrhagic), myocardial infarction, and vascular death up to 1 year after stroke onset. Results - A total of 1172 patients were analyzed for this study. Antiplatelet strategies pursued in study patients were MA group in 212 (18.1%), SA group in 246 (21.0%), and AA group in 714 (60.9%). The Cox proportional hazards regression analysis showed that, compared with the MA group, there was a reduction in the composite vascular event primary end point in the SA group (hazard ratio, 0.50; 95% confidence interval, 0.27-0.92; P=0.03) and in the AA group (hazard ratio, 0.40; 95% confidence interval, 0.24-0.66; P<0.001). Conclusions - This study showed that, compared with maintaining aspirin, switching to or adding alternative antiplatelet agents may be better in preventing subsequent vascular events in patients who experienced a new ischemic stroke while taking aspirin.

KW - antiplatelet agents

KW - aspirin

KW - multicenter studies

KW - stroke

UR - http://www.scopus.com/inward/record.url?scp=84952628459&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84952628459&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.115.011595

DO - 10.1161/STROKEAHA.115.011595

M3 - Article

VL - 47

SP - 128

EP - 134

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 1

ER -