Interruption to antiplatelet therapy early after acute ischaemic stroke: a nested case-control study

Area of Science:

• Cardiology
• Neurology
• Clinical Trials

Background:

• Antiplatelet therapy is crucial after ischemic stroke.
• Early discontinuation of antiplatelets is common due to non-compliance, complications, or care withdrawal.
• The impact of early antiplatelet cessation on stroke recurrence risk remains unclear.

Purpose of the Study:

• To investigate the association between cardiovascular event rates and adherence to antiplatelet therapy post-stroke.
• To determine if stopping or interrupting antiplatelet drugs increases the risk of recurrent cardiovascular events.

Main Methods:

• A matched case-control study design was employed using the Virtual International Stroke Trials Archive (VISTA).
• Cases experienced a cardiovascular event within 90 days post-stroke; controls were matched for age and sex.
• Antiplatelet use was categorized into persistent, early cessation (<3 days), or stopped/interrupted (>3 days but stopped before 90 days).

Main Results:

• The study included 970 patients (194 cases, 776 controls).
• No significant difference in cardiovascular event risk was observed for stopped/interrupted users (aOR 0.70) or early cessations (aOR 1.04) compared to persistent users.
• P-values for comparisons were 0.352 and 0.876, respectively.

Conclusions:

• Early stopping or interruption of antiplatelet therapy after ischemic stroke was not associated with an increased risk of cardiovascular events.
• The study's findings are limited by a small sample size.
• Further research is warranted to confirm these results in a larger population.