Relationship Between Neutrophil Count and 90‐Day Outcomes and Effect of Dual Antiplatelet Therapy in Patients With Acute Ischemic Stroke or Transient Ischemic Attack: A Post Hoc Analysis of the INSPIRES Trial

作者：Y. Wang, Y. Wang, Yuesong Pan, Xuan Wang, Ying Gao, Weiqi Chen, S. Claiborne Johnston, Philip M. Bath, Pierre Amarenco, Cong Gao, Yongjun Wang, Yongjun Wang, Xiaoling Liao, Yilong Wang, Yilong Wang · 发表于：Journal of the American Heart Association · 年份：2025 · DOI：10.1161/jaha.124.040492 · 被引用次数：3 · 研究领域：Antiplatelet Therapy and Cardiovascular Diseases、Acute Ischemic Stroke Management、Intracerebral and Subarachnoid Hemorrhage Research

BACKGROUND: Inflammation is an important mechanism in ischemic stroke and high-risk transient ischemic attack, but clinical inflammatory markers on antiplatelet therapy remain to be studied. This study was designed compare the neutrophil count (NC) on the efficacy and safety of clopidogrel-aspirin with that of aspirin in patients with ischemic stroke or high-risk transient ischemic attack caused by intracranial or extracranial atherosclerosis. METHODS: The INSPIRES (Intensive Statin and Antiplatelet Therapy for High-Risk Intracranial or Extracranial Atherosclerosis) study was a post hoc analysis of the multicenter, randomized, double-blind, placebo-controlled, 2-by-2 factorial trial. The primary efficacy and safety outcomes were 90-day stroke and moderate-to-severe bleeding. The differences in the efficacy outcome were calculated with cox proportional hazards model and the generalized linear model as well as logistic regression. RESULTS: /L). Patients with ischemic stroke or transient ischemic attack with a higher NC benefited more from clopidogrel-aspirin than from aspirin alone. There was no significant difference in the primary safety outcome of moderate-to-severe bleeding according to antiplatelet therapy or NC. CONCLUSIONS: The post hoc analysis suggested patients with a higher NC obtained greater benefit from clopidogrel-aspirin than from aspirin without an increase in bleeding risk. The findings may serve as a reference indicator for future anti-inflammatory therapy. H...