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STENOSIS: Long-term single versus dual antiplatelet therapy in patients with ischaemic stroke due to intracranial
Rohit Bhatia1, M V Padma Srivastava1, Risha Sarkar1
1Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
BMJ Neurology Open
|March 19, 2024
Summary
This study evaluates long-term dual antiplatelet therapy (DAPT) for intracranial atherosclerotic disease (ICAD). It assesses DAPT
Area of Science:
- Neurology
- Cardiology
- Clinical Trials
Background:
- Intracranial atherosclerotic disease (ICAD) causes progressive stenosis and cerebral hypoperfusion, increasing stroke risk.
- Optimal duration of dual antiplatelet therapy (DAPT) for ICAD is uncertain due to bleeding risks.
Purpose of the Study:
- To determine the efficacy and safety of up to 12 months of DAPT in patients with ICAD.
- To provide Level I evidence on DAPT duration for ischemic stroke secondary to ICAD.
Main Methods:
- Prospective, randomized, double-blind, placebo-controlled trial.
- Recruitment of 2200 patients with ICAD (50% stenosis or greater).
- Evaluation of primary outcomes including recurrent ischemic stroke and bleeding events at 12 months.
Main Results:
- Primary outcomes: recurrent ischemic stroke/transient ischemic attack vs. intracranial hemorrhage/systemic bleeding at 12 months.
- Secondary outcomes: composite of stroke, myocardial infarction, or death at 12 months.
- Safety outcomes: intracranial hemorrhage and systemic bleeding (GUSTO classification) at 12 months and 1 month post-treatment.
Conclusions:
- The study will establish evidence-based guidelines for DAPT duration in ICAD patients.
- Findings will inform clinical practice regarding stroke prevention and bleeding risk management in ICAD.
