scholarly journals Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) Trial: Rationale and design

2013 ◽  
Vol 8 (6) ◽  
pp. 479-483 ◽  
Author(s):  
S. Claiborne Johnston ◽  
J. Donald Easton ◽  
Mary Farrant ◽  
William Barsan ◽  
Holly Battenhouse ◽  
...  
Author(s):  
Kenichi Sakuta ◽  
Hiroshi Yaguchi ◽  
Ryoji Nakada ◽  
Takeo Sato ◽  
Tomomichi Kitagawa ◽  
...  

1993 ◽  
Vol 3 (6) ◽  
pp. 350-356
Author(s):  
Gheorghe A. Pop ◽  
Han J. Meeder ◽  
Wynsen van Oudenaarden ◽  
Jeannette C. van Latum ◽  
Wim Verweij ◽  
...  

2021 ◽  
Vol 27 ◽  
Author(s):  
Francesco Condello ◽  
Gaetano Liccardo ◽  
Giuseppe Ferrante

Background: Evidence about the use of dual antiplatelet therapy (DAPT) with aspirin and P2Y12 inhibitors in patients with acute minor ischemic stroke or transient ischemic attack (TIA) is emerging. The aim of our study was to provide an updated and comprehensive analysis about the risks and benefits of DAPT versus aspirin monotherapy in this setting. Methods: The PubMed, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov databases, main international conference proceedings were searched for randomized controlled trials comparing DAPT versus aspirin monotherapy in patients with acute ischemic stroke or TIA not eligible for thrombolysis or thrombectomy presenting in the first 24 hours after the acute event. Data were pooled by meta-analysis using a random-effects model. The primary efficacy endpoint was ischemic stroke recurrence, and the primary safety outcome was major bleeding. Secondary endpoints were intracranial hemorrhage, hemorrhagic stroke, and all-cause death. Results: A total of 4 studies enrolling 21,459 patients were included. DAPT with clopidogrel was used in 3 studies, DAPT with ticagrelor in one study. DAPT duration was 21 days in one study, 1 month in one study, and 3 months in the remaining studies. DAPT was associated with a significant reduction in the risk of ischemic stroke recurrence (relative risk [RR], 0.74; 95% confidence interval [CI], 0.67-0.82, P<0.001, number needed to treat 50 [95% CI 40-72], while it was associated with a significantly higher risk of major bleeding (RR, 2.59; 95% CI 1.49-4.53, P=0.001, number needed to harm 330 [95% CI 149-1111]), of intracranial hemorrhage (RR 3.06, 95% CI 1.41-6.66, P=0.005), with a trend towards higher risk of hemorrhagic stroke (RR 1.83, 95% CI 0.83-4.05, P=0.14), and a slight tendency towards higher risk of all-cause death (RR 1.30, 95% CI 0.89-1.89, P=0.16). Conclusions: Among patients with acute minor ischemic stroke or TIA, DAPT, as compared with aspirin monotherapy, might offer better effectiveness in terms of ischemic stroke recurrence at the expense of a higher risk of major bleeding. The trade-off between ischemic benefits and bleeding risks should be assessed in tailoring the therapeutic strategies.


2020 ◽  
Author(s):  
Zhongzhong Liu ◽  
Wenjuan Lin ◽  
Qingli Lu ◽  
Jing Wang ◽  
Pei Liu ◽  
...  

Abstract Background: The incidences of stroke recurrence, disability, and all-cause death of patients with minor ischemic stroke (MIS) remain problematic. The aim of the present was to identify risk factors associated with adverse outcomes at 1-year after MIS in the Xi’an region of China. Methods: The cohort of this prospective cohort study included MIS patients aged 18–97 years with a National Institutes of Health Stroke Scale (NIHSS) score of ≤ 3 who were treated in any of four hospitals in Xi’an region of China between January and December 2015. The 1-year percentage of stroke recurrence, disability, and all-cause death were evaluated. Multivariate logistic regression analysis was performed to assess the association between the identified risk factors and clinical outcomes. Results: Among the 1,121 patients included for analysis, the percentage of stroke recurrence, disability, and all-cause death at 1 year after MIS were 3.4% (38/1121), 9.3% (104/1121), and 3.3% (37/1121), respectively. Multivariate logistic regression analysis identified age, current smoking, and pneumonia as independent risk factors for stroke recurrence. Age, pneumonia, and alkaline phosphatase were independent risk factors for all-cause death. Independent risk factors for disability were age, pneumonia, NIHSS score on admission, and leukocyte count. Conclusions: The 1-year outcomes of MIS is not optimistic in the Xi’an region of China, especially high percentage of disability. In this study, we found the risk factors affecting 1-year stroke recurrence, disability and, all-cause death which need further verification in the subsequent studies.


2009 ◽  
Vol 287 (1-2) ◽  
pp. 147-150 ◽  
Author(s):  
Toshiyasu Ogata ◽  
Masahiro Yasaka ◽  
Yoshiyuki Wakugawa ◽  
Setsuro Ibayashi ◽  
Yasushi Okada

2017 ◽  
Vol 12 (7) ◽  
pp. 724-731 ◽  
Author(s):  
H Myrthe Boss ◽  
Sander M Van Schaik ◽  
Theo D Witkamp ◽  
Mirjam I Geerlings ◽  
Henry C Weinstein ◽  
...  

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Sungwook Yu ◽  
YooHwan Kim ◽  
Kyung-Hee Cho ◽  
Byung-Jo Kim

Introduction: Minor stroke or transient ischemic attack (TIA) is considered to have little effect on autonomic functions. However, it is unclear whether autonomic dysfunction in patients with minor stroke develops during acute stroke phase. Hypothesis: We evaluated whether patients with minor stroke had autonomic dysfunction during acute stroke phase. Methods: Patients with ischemic stroke or TIA were included. Those with diabetes and urological problems were excluded. Quantitative sudomotor axon reflex test (QSART), head-up tilt test (HUTT), sympathetic skin response (SSR), and heart rate variability (HRV) were performed during admission after acute stroke onset. HRV frequency measurements included time-domain and frequency-domain parameters. We analyzed the difference of autonomic function among patients with minor stroke (NIHSS score ≤ 3), major stroke (NIHSS score≥3) and TIA. Results: Total of 81 patients was included. There were 55 with minor ischemic stroke, 15 with major ischemic stroke, and 11 with TIA. RR interval of HRV was significantly different among three groups (938.8 ± 99.1 ms in TIA, 871.4 ± 104.9 ms in minor stroke, and 832.7 ± 107.8 ms in major stroke, P = 0.042). Parameters of HRV in patients with stroke had significantly lower compared to those with TIA [high frequency (HF) 8.9 ± 3.6 ms2 vs 12.2 ± 5.0 ms2, respectively, P = 0.013; the square root of the mean of the sum of the squares of differences between adjacent NN intervals (RMSSD), 23.5 ± 9.3 ms vs 30.7 ± 11.6 ms, respectively, P = 0.023]. Moreover, HF and RMSSD significantly decreased in patients with minor stroke compared to those with TIA (HF, 8.9 ± 3.6 ms2 vs 12.2 ± 5.0 ms2, respectively, P = 0.038; RMSSD, 23.2 ± 9.4 ms vs 30.7 ± 11.6 ms, respectively, P = 0.05). Results of QSART, HUTT and SSR were not different among three groups. Conclusion: Patients with minor stroke had decreased HRV compared to those with TIA, indicating that even minor stroke could be associated with decreased parasympathetic activity at early stroke phase. Further studies will be needed to evaluate effects of autonomic dysfunction on clinical outcome in patients with minor stroke.


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