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Sylaja PN, Nair SS, Pandian J, et al. Impact of Pre-Stroke Antiplatelet Use on 3-Month Outcome After Ischemic Stroke. Neurol India. 2021;69(6):1645-1649doi: 10.4103/0028-3886.333484.
Sylaja, P. N., Nair, S. S., Pandian, J., Khurana, D., Srivastava, M. V. P., Kaul, S., Arora, D., Sarma, P. S., & Singhal, A. B. (2021). Impact of Pre-Stroke Antiplatelet Use on 3-Month Outcome After Ischemic Stroke. Neurology India, 69(6), 1645-1649. https://doi.org/10.4103/0028-3886.333484
Sylaja, P N, et al. "Impact of Pre-Stroke Antiplatelet Use on 3-Month Outcome After Ischemic Stroke." Neurology India vol. 69,6 (2021): 1645-1649. doi: https://doi.org/10.4103/0028-3886.333484
Sylaja PN, Nair SS, Pandian J, Khurana D, Srivastava MVP, Kaul S, Arora D, Sarma PS, Singhal AB. Impact of Pre-Stroke Antiplatelet Use on 3-Month Outcome After Ischemic Stroke. Neurol India. 2021 Nov-Dec;69(6):1645-1649. doi: 10.4103/0028-3886.333484. PMID: 34979663.
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Neurol India. 2021 Nov-Dec;69(6):1645-1649. doi: 10.4103/0028-3886.333484.

Impact of Pre-Stroke Antiplatelet Use on 3-Month Outcome After Ischemic Stroke.

Neurology India

P N Sylaja, Sruthi S Nair, Jeyaraj Pandian, Dheeraj Khurana, M V Padma Srivastava, Subhash Kaul, Deepti Arora, P Sankara Sarma, Aneesh B Singhal

Affiliations

  1. Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
  2. Department of Neurology, Christian Medical College and Hospital, Ludhiana, Punjab, India.
  3. Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
  4. Department of Neurology, All India Institutes of Medical Sciences, New Delhi, India.
  5. Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India.
  6. Department of Biostatistics, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
  7. Department of Neurology, Stroke Service, Massachusetts General Hospital, Boston, USA.

PMID: 34979663 DOI: 10.4103/0028-3886.333484

Abstract

BACKGROUND: Pre-stroke anti-platelet (PAP) therapy can potentially influence the severity and outcome after ischemic stroke.

METHODS: We analyzed data from the prospective multicenter Indo-US collaborative stroke project for the impact of PAP therapy. Outcome measures included the admission National Institute of Health Stroke Scale (NIHSS) score, 3-month modified Rankin scale (mRS) score, and rates of in-hospital mortality and post-ischemic intracerebral hemorrhage.

RESULTS: Among 2048 of 2066 patients (M:F = 2:1) with known pre-stroke medication status, 336 (16.3%) were on PAP therapy. As compared to the non-PAP group, the PAP group had significantly higher mean age (62.2 vs 57.4 years, P < 0.001) and significantly more men, vascular risk factors, cerebral microbleeds (12.8% vs 6.2%, P = 0.001) and intravenous thrombolysis treatment (17% vs. 10.6%, P = 0.001). Cardioembolic strokes were significantly more in the PAP group (P < 0.001), but not large artery atherosclerosis. No significant differences were observed in the median NIHSS score (9 vs. 10, P = 0.274), 3-month mRS (score 0-2,51.4% vs. 49.0%, P = 0.428), in-hospital mortality (8.6% vs. 7.8%, P = 0.592), or symptomatic post ischemic intracerebral haemorrhage (12.2% vs. 10.6%, P = 0.382). The PAP group had more stroke recurrence (6.6% vs. 2.9%, P = 0.002) which was not significant (P = 0.065) after multivariate regression analysis adjusting for age, sex and vascular risk factors. PAP therapy was not an independent predictor of initial stroke severity or stroke outcome.

CONCLUSION: PAP therapy has no significant effect on initial stroke severity, rates of post-ischemic hemorrhage with or without thrombolysis, in-hospital mortality, stroke recurrence, and 3-month outcome after ischemic stroke.

Keywords: Antiplatelets; outcome; stroke recurrence; stroke severity

Conflict of interest statement

None

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