Prestroke antiplatelet agents in first-ever ischemic stroke: Clinical effects

Jin-Man Jung, Jungsoon Choi, Mi Yeon Eun, Woo Keun Seo, Kyung-Hee Cho, Sungwook Yu, Kyungmi Oh, Soonwoong Hong, Kwang Yeol Park

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: To investigate whether prestroke antiplatelet agent (PA) use was associated with initial stroke severity. Methods: This was a retrospective, case-control study based on data from a prospectively collected hospital-based stroke registry (Korea University Stroke Registry). A total of 3,025 patients who were admitted with a diagnosis of first-ever ischemic stroke within 5 days of symptom onset were included. Stroke severity was measured with the NIH Stroke Scale (NIHSS). NIHSS score ≤4 at admission was categorized as mild stroke. Patients from the PA group were matched with those from the non-PA group using estimated propensity scores at a 1:1 ratio. Stepwise multivariable logistic regression analyses were performed on patients in the matched datasets with initial mild stroke. Results: Patients' mean age was 66.3 ± 13.0 years, and 1,850 were men (61.5%). A total of 748 patients had been taking antiplatelet agents prior to stroke onset; 644 patients (86.1%) were taking a single antiplatelet agent. Among these agents, aspirin (83.7%) was the most common. A total of 102 patients (13.6%) were taking 2 antiplatelet agents. Multivariable analysis after propensity score matching demonstrated that PA use was associated with initial mild stroke (odds ratio 1.344; 95% confidence interval 1.014-1.782). Conclusions: PA use was associated with decreased first-ever stroke severity, suggesting that it has a beneficial effect. Classification of evidence: This study provides Class II evidence that prestroke use of antiplatelet agents reduces stroke severity in patients with first-ever acute ischemic stroke.

Original languageEnglish
Pages (from-to)1080-1089
Number of pages10
JournalNeurology
Volume84
Issue number11
DOIs
Publication statusPublished - 2015 Jan 1

Fingerprint

Platelet Aggregation Inhibitors
Stroke
Propensity Score
Registries
Korea
Aspirin
Case-Control Studies
Research Design

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Prestroke antiplatelet agents in first-ever ischemic stroke : Clinical effects. / Jung, Jin-Man; Choi, Jungsoon; Eun, Mi Yeon; Seo, Woo Keun; Cho, Kyung-Hee; Yu, Sungwook; Oh, Kyungmi; Hong, Soonwoong; Park, Kwang Yeol.

In: Neurology, Vol. 84, No. 11, 01.01.2015, p. 1080-1089.

Research output: Contribution to journalArticle

Jung, Jin-Man ; Choi, Jungsoon ; Eun, Mi Yeon ; Seo, Woo Keun ; Cho, Kyung-Hee ; Yu, Sungwook ; Oh, Kyungmi ; Hong, Soonwoong ; Park, Kwang Yeol. / Prestroke antiplatelet agents in first-ever ischemic stroke : Clinical effects. In: Neurology. 2015 ; Vol. 84, No. 11. pp. 1080-1089.
@article{a9e7e6d3d0b641a18f9dcf48fa1e7830,
title = "Prestroke antiplatelet agents in first-ever ischemic stroke: Clinical effects",
abstract = "Objective: To investigate whether prestroke antiplatelet agent (PA) use was associated with initial stroke severity. Methods: This was a retrospective, case-control study based on data from a prospectively collected hospital-based stroke registry (Korea University Stroke Registry). A total of 3,025 patients who were admitted with a diagnosis of first-ever ischemic stroke within 5 days of symptom onset were included. Stroke severity was measured with the NIH Stroke Scale (NIHSS). NIHSS score ≤4 at admission was categorized as mild stroke. Patients from the PA group were matched with those from the non-PA group using estimated propensity scores at a 1:1 ratio. Stepwise multivariable logistic regression analyses were performed on patients in the matched datasets with initial mild stroke. Results: Patients' mean age was 66.3 ± 13.0 years, and 1,850 were men (61.5{\%}). A total of 748 patients had been taking antiplatelet agents prior to stroke onset; 644 patients (86.1{\%}) were taking a single antiplatelet agent. Among these agents, aspirin (83.7{\%}) was the most common. A total of 102 patients (13.6{\%}) were taking 2 antiplatelet agents. Multivariable analysis after propensity score matching demonstrated that PA use was associated with initial mild stroke (odds ratio 1.344; 95{\%} confidence interval 1.014-1.782). Conclusions: PA use was associated with decreased first-ever stroke severity, suggesting that it has a beneficial effect. Classification of evidence: This study provides Class II evidence that prestroke use of antiplatelet agents reduces stroke severity in patients with first-ever acute ischemic stroke.",
author = "Jin-Man Jung and Jungsoon Choi and Eun, {Mi Yeon} and Seo, {Woo Keun} and Kyung-Hee Cho and Sungwook Yu and Kyungmi Oh and Soonwoong Hong and Park, {Kwang Yeol}",
year = "2015",
month = "1",
day = "1",
doi = "10.1212/WNL.0000000000001361",
language = "English",
volume = "84",
pages = "1080--1089",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "11",

}

TY - JOUR

T1 - Prestroke antiplatelet agents in first-ever ischemic stroke

T2 - Clinical effects

AU - Jung, Jin-Man

AU - Choi, Jungsoon

AU - Eun, Mi Yeon

AU - Seo, Woo Keun

AU - Cho, Kyung-Hee

AU - Yu, Sungwook

AU - Oh, Kyungmi

AU - Hong, Soonwoong

AU - Park, Kwang Yeol

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Objective: To investigate whether prestroke antiplatelet agent (PA) use was associated with initial stroke severity. Methods: This was a retrospective, case-control study based on data from a prospectively collected hospital-based stroke registry (Korea University Stroke Registry). A total of 3,025 patients who were admitted with a diagnosis of first-ever ischemic stroke within 5 days of symptom onset were included. Stroke severity was measured with the NIH Stroke Scale (NIHSS). NIHSS score ≤4 at admission was categorized as mild stroke. Patients from the PA group were matched with those from the non-PA group using estimated propensity scores at a 1:1 ratio. Stepwise multivariable logistic regression analyses were performed on patients in the matched datasets with initial mild stroke. Results: Patients' mean age was 66.3 ± 13.0 years, and 1,850 were men (61.5%). A total of 748 patients had been taking antiplatelet agents prior to stroke onset; 644 patients (86.1%) were taking a single antiplatelet agent. Among these agents, aspirin (83.7%) was the most common. A total of 102 patients (13.6%) were taking 2 antiplatelet agents. Multivariable analysis after propensity score matching demonstrated that PA use was associated with initial mild stroke (odds ratio 1.344; 95% confidence interval 1.014-1.782). Conclusions: PA use was associated with decreased first-ever stroke severity, suggesting that it has a beneficial effect. Classification of evidence: This study provides Class II evidence that prestroke use of antiplatelet agents reduces stroke severity in patients with first-ever acute ischemic stroke.

AB - Objective: To investigate whether prestroke antiplatelet agent (PA) use was associated with initial stroke severity. Methods: This was a retrospective, case-control study based on data from a prospectively collected hospital-based stroke registry (Korea University Stroke Registry). A total of 3,025 patients who were admitted with a diagnosis of first-ever ischemic stroke within 5 days of symptom onset were included. Stroke severity was measured with the NIH Stroke Scale (NIHSS). NIHSS score ≤4 at admission was categorized as mild stroke. Patients from the PA group were matched with those from the non-PA group using estimated propensity scores at a 1:1 ratio. Stepwise multivariable logistic regression analyses were performed on patients in the matched datasets with initial mild stroke. Results: Patients' mean age was 66.3 ± 13.0 years, and 1,850 were men (61.5%). A total of 748 patients had been taking antiplatelet agents prior to stroke onset; 644 patients (86.1%) were taking a single antiplatelet agent. Among these agents, aspirin (83.7%) was the most common. A total of 102 patients (13.6%) were taking 2 antiplatelet agents. Multivariable analysis after propensity score matching demonstrated that PA use was associated with initial mild stroke (odds ratio 1.344; 95% confidence interval 1.014-1.782). Conclusions: PA use was associated with decreased first-ever stroke severity, suggesting that it has a beneficial effect. Classification of evidence: This study provides Class II evidence that prestroke use of antiplatelet agents reduces stroke severity in patients with first-ever acute ischemic stroke.

UR - http://www.scopus.com/inward/record.url?scp=84925326063&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84925326063&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000001361

DO - 10.1212/WNL.0000000000001361

M3 - Article

C2 - 25672919

AN - SCOPUS:84925326063

VL - 84

SP - 1080

EP - 1089

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 11

ER -