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Aminotransferase Level and the Effects of Dual Antiplatelet in Minor Stroke or Transient Ischemic Attack: A post hoc Analysis of a Randomized Control Trial
First author：Suo, yue
Corresponding author：Wang, yongjun
essential_information
2022-12-09
Published articles
Journal：Cerebrovascular Diseases
Publication type: Original Contributions
IF(IF): 3.104
PMID: 36502795 Link To Pubmed Full text Download
Background And Purpose
Objectives of this study include:1)Compare the 3-month recurrence, death, dependency between subgroups of different level of de ritis ratio(AST/ALT), AST, ALT; 2)Evaluate the efficacy of dual antiplatelet vs single antiplatelet therapy in minor stroke and TIA in different subgroups according to level of de ritis ratio/abnormal liver function; 3)Investigate the influence of correlation between de ritis ratio/abnormal liver function（elevated transmerase） and CYP2C19 loss-of-function allele on effect of dual antiplatelet therapy.
Method
We will present the categorical variables as proportions, continuous variables as mean and SD. In the univariate analysis, Kruskal-Wallis test was used for comparisons of skewed continuous variables and ordinal variable. Categorical variables were compared with the x2 statistics or Fisher exact test as appropriate. Cox proportional hazard regression model and logistic regression model will be used to analyze the association of abnormal liver funcition and stroke recurrence. Stratified analysis by De ritis ratio, level of ALT, AST and CYP2C19 loss-of-function carrier status will also be performed. A two-sided P value of less than 0.05 will be considered to reach statistical significance. All statistical analyses will be performed by using SAS version 9.4 software (SAS Institute Inc., Cary, NC, USA).
Conclusion
Dual antiplatelet treatment was safe for minor stroke or high-risk TIA patients with mildly elevated aminotransferase. Mild elevation of ALT or AST did not undermine the protective efficacy of the dual antiplatelet regimen in reducing recurrent stroke or TIA within 90 days after MIS or TIA. The interaction between the CYP2C19 loss-of-function allele carrier status and aminotransferase level on the efficacy of dual antiplatelet treatment was not observed.