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Effect of dual versus mono antiplatelet therapy on recurrent stroke modulated by activated partial thromboplastin time.

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Title: Effect of dual versus mono antiplatelet therapy on recurrent stroke modulated by activated partial thromboplastin time.
Authors: Xie, X. (AUTHOR), Wang, X. (AUTHOR), Laskowitz, D. T. (AUTHOR), Zhao, X. (AUTHOR), Miao, Z. (AUTHOR), Liu, L. (AUTHOR), Li, H. (AUTHOR), Meng, X. (AUTHOR), Wang, Y. (AUTHOR)
Source: European Journal of Neurology. Sep2019, Vol. 26 Issue 9, p1168-1168. 1p. 4 Charts, 1 Graph.
Subjects: Partial thromboplastin time, Proportional hazards models, Stroke
Abstract: Background and purpose: The efficacy of dual antiplatelet treatment may be modified by many factors. The aim was to assess whether the effect of clopidogrel plus aspirin versus aspirin alone on recurrent stroke would be affected by admission activated partial thromboplastin time (aPTT). Methods: Data were derived from the Clopidogrel in High‐Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. A total of 5074 patients were categorized into three groups based on the aPTT distribution according to the 15th and 85th percentile. The primary outcome was any stroke within 90 days. The interaction of aPTT with antiplatelet therapy on stroke risk was assessed with a Cox proportional hazards model with adjustment for covariates. Results: In the high aPTT group (defined as ≥35.9 s), stroke occurred in 6.7% of patients in the clopidogrel–aspirin arm and 11.9% in the aspirin arm [adjusted hazard ratio (HR) 0.50; 95% confidence interval (CI) 0.29–0.85]. In the medium aPTT group (24.6–35.8 s), stroke occurred in 7.7% of patients in the clopidogrel–aspirin arm and 11.8% in the aspirin arm (adjusted HR 0.62; 95% CI 0.50–0.75). Furthermore, in the low aPTT group (≤24.5 s), stroke occurred in 11.2% of patients in the clopidogrel–aspirin arm and 9.9% in the aspirin arm (adjusted HR 1.07; 95% CI 0.65–1.62). The interaction P value of antiplatelet therapy with aPTT level at the cut‐point of approximately 25 s or below was significant (P < 0.05). Conclusions: Dual antiplatelet therapy was superior to single antiplatelet therapy in the high or medium aPTT group but not in the low aPTT group. [ABSTRACT FROM AUTHOR]
Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Effect of dual versus mono antiplatelet therapy on recurrent stroke modulated by activated partial thromboplastin time.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Xie%2C+X%2E%22&quot;&gt;Xie, X.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Wang%2C+X%2E%22&quot;&gt;Wang, X.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Laskowitz%2C+D%2E+T%2E%22&quot;&gt;Laskowitz, D. T.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Zhao%2C+X%2E%22&quot;&gt;Zhao, X.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Miao%2C+Z%2E%22&quot;&gt;Miao, Z.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Liu%2C+L%2E%22&quot;&gt;Liu, L.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Li%2C+H%2E%22&quot;&gt;Li, H.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Meng%2C+X%2E%22&quot;&gt;Meng, X.&lt;/searchLink&gt; (AUTHOR)&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Wang%2C+Y%2E%22&quot;&gt;Wang, Y.&lt;/searchLink&gt; (AUTHOR)
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22European+Journal+of+Neurology%22&quot;&gt;European Journal of Neurology&lt;/searchLink&gt;. Sep2019, Vol. 26 Issue 9, p1168-1168. 1p. 4 Charts, 1 Graph.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Partial+thromboplastin+time%22&quot;&gt;Partial thromboplastin time&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Proportional+hazards+models%22&quot;&gt;Proportional hazards models&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Stroke%22&quot;&gt;Stroke&lt;/searchLink&gt;
– Name: Abstract
  Label: Abstract
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  Data: Background and purpose: The efficacy of dual antiplatelet treatment may be modified by many factors. The aim was to assess whether the effect of clopidogrel plus aspirin versus aspirin alone on recurrent stroke would be affected by admission activated partial thromboplastin time (aPTT). Methods: Data were derived from the Clopidogrel in High‐Risk Patients with Acute Nondisabling Cerebrovascular Events (CHANCE) trial. A total of 5074 patients were categorized into three groups based on the aPTT distribution according to the 15th and 85th percentile. The primary outcome was any stroke within 90&#160;days. The interaction of aPTT with antiplatelet therapy on stroke risk was assessed with a Cox proportional hazards model with adjustment for covariates. Results: In the high aPTT group (defined as ≥35.9&#160;s), stroke occurred in 6.7% of patients in the clopidogrel–aspirin arm and 11.9% in the aspirin arm [adjusted hazard ratio (HR) 0.50; 95% confidence interval (CI) 0.29–0.85]. In the medium aPTT group (24.6–35.8&#160;s), stroke occurred in 7.7% of patients in the clopidogrel–aspirin arm and 11.8% in the aspirin arm (adjusted HR 0.62; 95% CI 0.50–0.75). Furthermore, in the low aPTT group (≤24.5&#160;s), stroke occurred in 11.2% of patients in the clopidogrel–aspirin arm and 9.9% in the aspirin arm (adjusted HR 1.07; 95% CI 0.65–1.62). The interaction P value of antiplatelet therapy with aPTT level at the cut‐point of approximately 25&#160;s or below was significant (P&#160;&lt;&#160;0.05). Conclusions: Dual antiplatelet therapy was superior to single antiplatelet therapy in the high or medium aPTT group but not in the low aPTT group. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
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  Data: &lt;i&gt;Copyright of European Journal of Neurology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1111/ene.13961
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      – Code: eng
        Text: English
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        PageCount: 1
        StartPage: 1168
    Subjects:
      – SubjectFull: Partial thromboplastin time
        Type: general
      – SubjectFull: Proportional hazards models
        Type: general
      – SubjectFull: Stroke
        Type: general
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      – TitleFull: Effect of dual versus mono antiplatelet therapy on recurrent stroke modulated by activated partial thromboplastin time.
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              M: 09
              Text: Sep2019
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