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February 14, 2006; 66 (3) Articles

Premorbid antiplatelet use and ischemic stroke outcomes

N. Sanossian, J. L. Saver, V. Rajajee, S. L. Selco, D. Kim, T. Razinia, B. Ovbiagele
First published December 28, 2005, DOI: https://doi.org/10.1212/01.wnl.0000195889.05792.f1
N. Sanossian
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J. L. Saver
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V. Rajajee
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S. L. Selco
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D. Kim
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T. Razinia
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B. Ovbiagele
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Citation
Premorbid antiplatelet use and ischemic stroke outcomes
N. Sanossian, J. L. Saver, V. Rajajee, S. L. Selco, D. Kim, T. Razinia, B. Ovbiagele
Neurology Feb 2006, 66 (3) 319-323; DOI: 10.1212/01.wnl.0000195889.05792.f1

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Abstract

Objective: To evaluate the independent effect of premorbid antiplatelet use on incident ischemic stroke severity and outcome at discharge.

Methods: The authors studied consecutive patients presenting within 24 hours of ischemic stroke over a 1-year period. National Institutes of Health Stroke Scale (NIHSS) score at presentation was used as index of stroke severity and a modified Rankin scale of 0 to1 at discharge as index of good functional outcome. Patients were categorized according to their premorbid antiplatelet use as antiplatelet-inclusive (AI) and no antiplatelet (NA). Demographic data, risk factors, pertinent laboratory tests, other medications, and stroke mechanisms were controlled for across the two groups using multivariate logistic regression.

Results: A total of 260 individuals met study criteria: 92 patients were on antiplatelet agents prior to admission, 168 were on no antiplatelets. Pretreatment with antiplatelet was associated with lower presenting median NIHSS (4.5 vs 7, p = 0.005). Antiplatelet use was associated with less severe stroke at presentation in those having no history of stroke or TIA (4.8 vs 8.0, p = 0.03) but not in those with a prior history of stroke or TIA (4.9 vs 4.9, p = 0.987). The likelihood of a good outcome was increased in those on antiplatelets after adjusting for other variables (OR 2.105, p = 0.0073).

Conclusions: Prestroke use of antiplatelet may be associated with reduced severity of incident ischemic strokes in those with no prior history of stroke or TIA, and with an increased likelihood of a good discharge outcome regardless of prior cerebrovascular event history.

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Disputes & Debates: Rapid online correspondence

  • Premorbid antiplatelet use and ischemic stroke outcomes
    • Hai-feng Li, Department of Neurology, Affiliated Hospital of Medical College, Qingdao University
    • Xu-dong Pan
    Published May 09, 2006
  • Reply from the authors
    • Nerses Sanossian, UCLA Stroke Center
    • Bruce Ovbiagele
    Published May 09, 2006
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