Title :

Outcomes after stroke thrombolysis according to prior antiplatelet use

Author(s) :

Meseguer, Elena [Auteur]
Labreuche, Julien [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Guidoux, Céline [Auteur]
Lavallee, Philippa C. [Auteur]
Cabrejo, Lucie [Auteur]
Sirimarco, Gaia [Auteur]
Valcarcel, Jaime G. [Auteur]
Klein, Isabelle F. [Auteur]
Amarenco, Pierre [Auteur]
Mazighi, Mikael [Auteur]

Journal title :

International journal of stroke . official journal of the International Stroke Society

Abbreviated title :

Int. J. Stroke

Volume number :

10

Pages :

163-169

Publication date :

2015-02-01

ISSN :

1747-4930

English keyword(s) :

antiplatelet
thrombolysis
tpa
stroke
ischemic stroke
aspirin

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

BACKGROUND: Thirty percent of ischemic stroke (IS) patients suffering from acute stroke are under antiplatelet therapy. OBJECTIVE: We evaluated whether prior antiplatelet use before intravenous (IV), intra-arterial (IA) ...
Show more >BACKGROUND: Thirty percent of ischemic stroke (IS) patients suffering from acute stroke are under antiplatelet therapy. OBJECTIVE: We evaluated whether prior antiplatelet use before intravenous (IV), intra-arterial (IA) or combined IV/IA therapy may be associated with worse outcomes and an increased intracerebral hemorrhage (ICH) risk after reperfusion therapies. METHODS: We analyzed data from our patient registry (n = 874) and conducted a systematic review of previous observational studies. The primary outcome was the percentage of patients who developed symptomatic ICH (sICH), defined in our registry per ECASS-II definition. RESULTS: We identified 43 previous reports that evaluated the impact of prior antiplatelet use on outcomes after reperfusion therapy in AIS patients. Prior antiplatelet use was found in 35% of AIS patients, eligible for reperfusion therapies and was associated with a worse vascular profile. In an unadjusted meta-analysis that included our registry data, prior antiplatelet use was associated with more sICH per ECASS-II definition (OR, 1.78 (95% CI, 1.48-2.13), and less favorable outcome (OR, 0.86; 95% CI, 0.77-0.98). However, in multivariate analyses conducted in our registry showed that prior antiplatelet use was not associated with worse outcome (P > 0.23); and in the systematic review, only 3 studies reported a slight, but significant adjusted increase in sICH risk, of whom one had conflicting results according to sICH definition. CONCLUSIONS: These results suggest no significant detrimental effect of prior antiplatelet use in AIS patients treated by IV, IA or combined IV/IA therapy. Further studies are needed to assess the specific impact of different and cumulative antiplatelet agents.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Université de Lille

Collections :

• METRICS : Evaluation des technologies de santé et des pratiques médicales - ULR 2694

Submission date :

2019-12-09T16:56:14Z