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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Risk of Early Bleeding with Dual Antiplatelet Therapy in Acute Stroke and Transient Ischemic Attack Regardless of NIHSS Admission
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Risk of Early Bleeding with Dual Antiplatelet Therapy in Acute Stroke and Transient Ischemic Attack Regardless of NIHSS Admission

机译：急性中风和短暂性缺血症患者早期出血的风险，无论NIHSS入场如何

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Background: Dual antiplatelet therapy (DAT) is a therapeutic option for patients with minor ischemic stroke (IS) or transient ischemic attack (TIA). No study has evaluated the incidence of early bleeding in patients with moderate to major ischemic stroke. The current study aimed to analyze both the frequency of early bleeding and hospital morbidity related to DAT for either acute IS or TIA regardless of admission National Institute of Health Stroke Scale (NIHSS) score. Methods: This was a retrospective analysis based on data collected from a prospective data bank of a single center. We included patients who underwent DAT in the first 24 hours of symptom onset with a loading dose (aspirin 300 mg + clopidogrel 300 mg) on the first day, followed by a maintenance dose (aspirin 100 mg + clopidogrel 75 mg). We analyzed intracranial and/or extracranial hemorrhage that had occurred during the hospital admission, symptomatic bleeding, modified Rankin Scale (mRS) score at discharge, and death rates as outcomes. Results: Of the 119 patients analyzed, 94 (79 %) had IS and 25 (21 %) had TIA. Hemorrhage occurred in 11 (9.2 %) and four (3.4 %) patients with TIA or NIHSS < 3, respectively, although none were symptomatic. Patients with bleeding as a complication had higher admission NIHSS [4 (3-7) vs. 2 (1-4), p = 0.044] and had higher mRS at discharge (mRS 2 [1-5] vs. mRS 1 [0-2], p = 0.008). These findings did not indicate increased mortality, as one (9 %) patient died from bleeding and two (1.8 %) patients died without bleeding (p = 0.254). Conclusion: DAT seems to be a safe therapy in patients regardless of admission NIHSS if started within the first 24 h after symptom onset because only 1.6 % of patients had symptomatic bleeding.
机译：背景：双重抗血小板治疗（DAT）是轻度缺血性中风（is）或短暂性脑缺血发作（TIA）患者的一种治疗选择。没有研究评估中重度缺血性卒中患者早期出血的发生率。目前的研究旨在分析急性IS或TIA患者的早期出血频率和与DAT相关的医院发病率，而不考虑入院时美国国立卫生研究院卒中量表（NIHSS）评分。方法：根据从单个中心的前瞻性数据库收集的数据进行回顾性分析。我们包括在症状出现的前24小时接受DAT治疗的患者，第一天服用负荷剂量（阿司匹林300 mg+氯吡格雷300 mg），然后服用维持剂量（阿司匹林100 mg+氯吡格雷75 mg）。我们分析了住院期间发生的颅内和/或颅外出血、症状性出血、出院时的改良Rankin评分（mRS）以及死亡率作为结果。结果：在分析的119例患者中，94例（79%）患有IS，25例（21%）患有TIA。TIA或NIHSS<3的患者中，分别有11例（9.2%）和4例（3.4%）发生出血，但均无症状。作为并发症出血的患者入院时NIHSS[4（3-7）比2（1-4），p=0.044]更高，出院时mRS更高（mRS 2[1-5]比mRS 1[0-2]，p=0.008）。这些发现并不表明死亡率增加，因为一名（9%）患者死于出血，两名（1.8%）患者死于无出血（p=0.254）。结论：无论NIHSS是否入院，只要在症状出现后24小时内开始，DAT似乎都是一种安全的治疗方法，因为只有1.6%的患者有症状性出血。

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