Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases
Comparison of Outcome of Patients with Acute Minor Ischemic Stroke Treated with IV t-PA, DAPT or Aspirin
First author：Peng Wang,Mengyuan Zhou
Corresponding author：Yilong Wang
essential_information
- Person in charge：Peng Wang,Mengyuan Zhou
- Data Sources： CHANCE
- Number of papers：CHANCE20200228
- Published time：2020-10-19
2020-10-19
Published articles
Journal：Stroke and Vascular Neurology
Publication type: Original Contributions
IF(IF): 4.081
PMID: 33077680 Link To Pubmed Full text Download
Background And Purpose
Whether to treat minor stroke with intravenous tissue plasminogen activator (t-PA) treatment or antiplatelet therapy is a dilemma. Our study aimed to explore whether intravenous t-PA treatment, dual antiplatelet therapy (DAPT) and aspirin have different efficacies on outcomes in patients with minor stroke.
Method
A post hoc analysis of patients with acute minor stroke treated with intravenous t-PA within 4.5 hours from a nationwide multicentric electronic medical record and patients with acute minor stroke treated with DAPT and aspirin from the Clopidogrel with Aspirin in Acute Minor Stroke or Transient Ischemic Attack Database. Minor stroke was defined by a score of 0-3 on the National Institutes of Health Stroke Scale at randomisation. Favourable functional outcome (defined as modified Rankin Scale (mRS) score of 0-1 or 0-2 at 3 months).
Conclusion
In our study, no significant advantage of intravenous t-PA over DAPT or aspirin was found. Due to insufficient sample size, our study is probably unable to draw such a conclusion that that intravenous t-PA was superior or non-superior to DAPT.
Main results
Compared with those treated with intravenous t-PA, no significant association with 3-month favourable functional outcome (defined as mRS score of 0-1) was found neither in patients treated with aspirin (87.8% vs 89.4%; OR, 0.83; 95% CI, 0.46 to 1.50; p=0.53) nor those treated with DAPT (87.4% vs 89.4%; OR, 0.84; 95% CI, 0.46 to 1.52; p=0.56). Similar results were observed for the favourable functional outcome defined as mRS score of 0-2 at 3 months.