Details

Autor(en) / Beteiligte

• De Matteis, Eleonora
• Ornello, Raffaele
• De Santis, Federico
• Foschi, Matteo
• Romoli, Michele
• Tassinari, Tiziana
• Saia, Valentina
• Cenciarelli, Silvia
• Bedetti, Chiara
• Padiglioni, Chiara
• Censori, Bruno
• Puglisi, Valentina
• Vinciguerra, Luisa
• Guarino, Maria
• Barone, Valentina
• Zedde, Marialuisa
• Grisendi, Ilaria
• Diomedi, Marina
• Bagnato, Maria Rosaria
• Petruzzellis, Marco
• Mezzapesa, Domenico Maria
• Di Viesti, Pietro
• Inchingolo, Vincenzo
• Cappellari, Manuel
• Zenorini, Mara
• Candelaresi, Paolo
• Andreone, Vincenzo
• Rinaldi, Giuseppe
• Bavaro, Alessandra
• Cavallini, Anna
• Moraru, Stefan
• Querzani, Pietro
• Terruso, Valeria
• Mannino, Marina
• Pezzini, Alessandro
• Frisullo, Giovanni
• Muscia, Francesco
• Paciaroni, Maurizio
• Mosconi, Maria Giulia
• Zini, Andrea
• Leone, Ruggiero
• Palmieri, Carmela
• Cupini, Letizia Maria
• Marcon, Michela
• Tassi, Rossana
• Sanzaro, Enzo
• Paci, Cristina
• Viticchi, Giovanna
• Orsucci, Daniele
• Falcou, Anne
• Diamanti, Susanna
• Tarletti, Roberto
• Nencini, Patrizia
• Rota, Eugenia
• Sepe, Federica Nicoletta
• Ferrandi, Delfina
• Caputi, Luigi
• Volpi, Gino
• Spada, Salvatore La
• Beccia, Mario
• Rinaldi, Claudia
• Mastrangelo, Vincenzo
• Di Blasio, Francesco
• Invernizzi, Paolo
• Pelliccioni, Giuseppe
• De Angelis, Maria Vittoria
• Bonanni, Laura
• Ruzza, Giampietro
• Caggia, Emanuele Alessandro
• Russo, Monia
• Tonon, Agnese
• Acciarri, Maria Cristina
• Anticoli, Sabrina
• Roberti, Cinzia
• Manobianca, Giovanni
• Scaglione, Gaspare
• Pistoia, Francesca
• Fortini, Alberto
• De Boni, Antonella
• Sanna, Alessandra
• Chiti, Alberto
• Barbarini, Leonardo
• Caggiula, Marcella
• Masato, Maela
• Del Sette, Massimo
• Passarelli, Francesco
• Roberta Bongioanni, Maria
• Toni, Danilo
• Ricci, Stefano
• Sacco, Simona

Titel

Beyond RCTs: Short-term dual antiplatelet therapy in secondary prevention of ischemic stroke and transient ischemic attack

Ist Teil von

• European stroke journal, 2024-06, p.23969873241255250

Ort / Verlag

England

Erscheinungsjahr

2024

Quelle

EZB Electronic Journals Library

Beschreibungen/Notizen

• Randomized controlled trials (RCTs) proved the efficacy of short-term dual antiplatelet therapy (DAPT) in secondary prevention of minor ischemic stroke or high-risk transient ischemic attack (TIA). We aimed at evaluating effectiveness and safety of short-term DAPT in real-world, where treatment use is broader than in RCTs. READAPT (REAl-life study on short-term Dual Antiplatelet treatment in Patients with ischemic stroke or Transient ischemic attack) (NCT05476081) was an observational multicenter real-world study with a 90-day follow-up. We included patients aged 18+ receiving short-term DAPT soon after ischemic stroke or TIA. No stringent NIHSS and ABCD score cut-offs were applied but adherence to guidelines was recommended. Primary effectiveness outcome was stroke (ischemic or hemorrhagic) or death due to vascular causes, primary safety outcome was moderate-to-severe bleeding. Secondary outcomes were the type of ischemic and hemorrhagic events, disability, cause of death, and compliance to treatment. We included 1920 patients; 69.9% started DAPT after an ischemic stroke; only 8.9% strictly followed entry criteria or procedures of RCTs. Primary effectiveness outcome occurred in 3.9% and primary safety outcome in 0.6% of cases. In total, 3.3% cerebrovascular ischemic recurrences occurred, 0.2% intracerebral hemorrhages, and 2.7% bleedings; 0.2% of patients died due to vascular causes. Patients with NIHSS score ⩽5 and those without acute lesions at neuroimaging had significantly higher primary effectiveness outcomes than their counterparts. Additionally, DAPT start >24 h after symptom onset was associated with a lower likelihood of bleeding. In real-world, most of the patients who receive DAPT after an ischemic stroke or a TIA do not follow RCTs entry criteria and procedures. Nevertheless, short-term DAPT remains effective and safe in this population. No safety concerns are raised in patients with low-risk TIA, more severe stroke, and delayed treatment start.