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Published on: September 5, 2016
Premorbid antiplatelet use and ischemic stroke outcomes
N Sanossian1, J L Saver, V Rajajee
1Stroke Center, Department of Neurology, UCLA Medical Center, Los Angeles, CA, USA. nsanossian@mednet.ucla.edu
Neurology
|December 31, 2005
Summary
Prestroke antiplatelet use may reduce ischemic stroke severity, particularly in patients without prior stroke history. It also improves the likelihood of a good discharge outcome for all patients.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Public Health
Background:
- Antiplatelet agents are commonly used for primary and secondary prevention of cerebrovascular events.
- The impact of pre-existing antiplatelet therapy on acute ischemic stroke presentation and outcomes requires further elucidation.
Purpose of the Study:
- To determine the independent effect of premorbid antiplatelet use on the severity of incident ischemic strokes.
- To assess the association between pre-stroke antiplatelet use and functional outcomes at discharge following an ischemic stroke.
Main Methods:
- A cohort of 260 patients presenting with ischemic stroke within 24 hours was analyzed.
- Stroke severity was measured by the National Institutes of Health Stroke Scale (NIHSS) at presentation.
- Functional outcome was assessed using the modified Rankin Scale (mRS) at discharge, with multivariate logistic regression controlling for confounding factors.
Main Results:
- Patients on premorbid antiplatelets had a lower median NIHSS score at presentation (4.5 vs. 7, p=0.005).
- Antiplatelet use was linked to less severe strokes in patients with no prior stroke or TIA history (NIHSS 4.8 vs. 8.0, p=0.03).
- A good discharge outcome (mRS 0-1) was more likely in patients on antiplatelets (OR 2.105, p=0.0073), irrespective of prior cerebrovascular history.
Conclusions:
- Prestroke antiplatelet therapy may be associated with reduced ischemic stroke severity, especially in treatment-naive individuals.
- Antiplatelet use prior to stroke is independently associated with an increased likelihood of favorable functional recovery at discharge.
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