Dual Antiplatelet Therapy after Intravenous Thrombolysis for Acute Minor Ischemic Stroke

作者：Guangjian Zhao, Fanzhen Lin, Ziran Wang, Xiaolin Shao, Yanxue Gong, Shirui Zhang, Yansen Cui, Dai-Qun Yang, Hongyan Lei, Zhongrong Cheng, Liquan Wang, Guo Dongdong, Qinghua Zhang · 发表于：European Neurology · 年份：2019 · DOI：10.1159/000505241 · 被引用次数：18 · 研究领域：Acute Ischemic Stroke Management、Intracerebral and Subarachnoid Hemorrhage Research、Antiplatelet Therapy and Cardiovascular Diseases

OBJECTIVE: To verify the efficacy and safety of dual antiplatelet therapy after intravenous thrombolysis for acute minor ischemic stroke (AMIS). METHODS: AMIS patients who received recombinant tissue plasminogen activator (rt-PA) intravenous thrombolysis from January to October 2018 were retrospectively analyzed and divided into the aspirin (ASP) and ASP + clopidogrel (ASP-CLO) groups based on the type of antiplatelet therapy to compare the rates of good clinical outcome, symptomatic intracranial hemorrhage (SICH) after thrombolysis, and mortality in 90 days. RESULTS: A total of 207 patients were included (group ASP, 105 patients; group ASP-CLO, 102 patients). There was no significant difference in the baseline clinical data between the 2 groups. The -90-day modified Rankin scale scores (66.7 vs. 82.4%, p = 0.009) showed a statistically significant difference, but SICH (1.0 vs. 1.0%, p = 0.917) and 90-day mortality (1.9 vs. 1.0%, p = 0.585) showed no significant difference between the 2 groups. CONCLUSIONS: Short-term (21 days) dual antiplatelet therapy after rt-PA intravenous thrombolysis for AMIS can improve the prognosis, reduce the risk of stroke recurrence, without increasing the risk of bleeding and mortality.