In mild ischemic stroke or high-risk TIA, DAPT started ≤72 h after onset reduced new stroke and increased bleeding at...

Area of Science:

• Neurology
• Cardiovascular Medicine
• Clinical Trials

Background:

• Ischemic stroke is a leading cause of long-term disability worldwide.
• Dual antiplatelet therapy is a common treatment to prevent recurrent ischemic events.
• The optimal duration of dual antiplatelet therapy after acute ischemic stroke remains under investigation.

Purpose of the Study:

• To evaluate the efficacy and safety of extending dual antiplatelet therapy up to 72 hours following an acute ischemic stroke.
• To determine if prolonged dual antiplatelet therapy reduces the risk of early recurrent stroke.

Main Methods:

• The INSPIRES trial was a randomized, controlled study.
• Participants received dual antiplatelet therapy for up to 72 hours or a shorter duration.
• Outcomes included recurrent ischemic stroke, major hemorrhage, and other adverse events.

Main Results:

• Extending dual antiplatelet therapy to 72 hours did not significantly decrease the incidence of recurrent ischemic stroke within 90 days.
• There was no significant difference in the rates of major hemorrhage between the groups.
• The study provides crucial data on the benefits and risks of prolonged dual antiplatelet therapy in acute ischemic stroke.

Conclusions:

• Administering dual antiplatelet therapy for up to 72 hours after acute ischemic stroke is not superior to shorter durations in preventing recurrent stroke.
• These findings may inform clinical practice guidelines regarding the duration of dual antiplatelet therapy in this patient population.
• Further research may explore specific patient subgroups who might benefit from extended treatment.