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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Stroke+Vasc+Neurol
2017 ; 2
(4
): 176-183
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gab.com Text
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Risk factors associated with 90-day recurrent stroke in patients on dual
antiplatelet therapy for minor stroke or high-risk TIA: a subgroup analysis of
the CHANCE trial
#MMPMID29507777
Wangqin R
; Wang X
; Wang Y
; Xian Y
; Zhao X
; Liu L
; Li H
; Meng X
; Wang Y
Stroke Vasc Neurol
2017[Dec]; 2
(4
): 176-183
PMID29507777
show ga
OBJECTIVE: Many patients receiving dual antiplatelet therapy still had recurrent
strokes. We aimed to identify factors associated with recurrent stroke at 90 days
in patients receiving dual antiplatelet therapy in Clopidogrel in High-risk
patients with Acute Non-disabling Cerebrovascular Events trial. METHODS: Patients
with transient ischaemic attack or minor stroke receiving clopidogrel and aspirin
in the trial were analysed in the study. The primary outcome was recurrent stroke
within 90 days after the index event. Cox proportional hazard model with backward
selection was used to identify factors associated with stroke. RESULTS: Among
2584 patients, 212 (8.2%) had a recurrent stroke, 216 (8.4%) had a composite of
stroke, myocardial infarction, or vascular death and 204 (7.9%) had ischaemic
stroke within 90 days. Multivariate analysis identified the following factors
associated with stroke: history of hypertension with poor blood pressure control
(HR, 1.92; 95% CI 1.22 to 3.03), the high baseline National Institute of Health
Stroke Scale (NIHSS) score of 2 and 3 (2.12 (1.07 to 4.21) and 4.11 (2.05 to
8.22), respectively), time from onset to randomisation of <12?hours (1.47 (1.12
to 1.94)), the lipid-lowering therapy (0.61 (0.47 to 0.83)), the open-label
aspirin dose at day 1 of ?300?mg (1.98 (1.45 to 2.69)). Intracranial arterial
stenosis (ICAS) was significantly associated with stroke in the sensitivity
analysis (2.17 (1.16 to 4.04)). CONCLUSIONS: The high baseline NIHSS score,
hypertension with poor blood pressure control, ICAS, time from onset to
randomisation of less than 12?hours and no lipid-lowering therapy were associated
with stroke, suggesting that patients with identified predictors still remain to
be at high risk of recurrent stroke although being under the dual antiplatelet
therapy. TRIAL REGISTRATION NUMBER: http://clinicaltrials.gov/show/NCT00979589.
ClinicalTrials.gov number: NCT00979589.