Premorbid antiplatelet use was associated with lower presenting stroke severity (median NIHSS 4.5 vs 7, p=0.005) and increased likelihood of good discharge outcome (OR 2.105, p=0.0073).
Cohort (n=260)
Does premorbid antiplatelet use reduce stroke severity and improve functional outcomes at discharge in patients presenting with acute ischemic stroke?
Premorbid antiplatelet use is associated with reduced initial stroke severity in patients without prior cerebrovascular events and improved functional outcomes at discharge overall.
Effect estimate: OR 2.105
Absolute Event Rate: 4.5% vs 7%
p-value: p=0.0073
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 to 1 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.
Sanossian et al. (Mon,) conducted a cohort in Ischemic stroke (n=260). Premorbid antiplatelet use vs. No antiplatelet use was evaluated on Incident ischemic stroke severity (NIHSS score at presentation) and good functional outcome at discharge (mRS 0-1) (OR 2.105, p=0.0073). Premorbid antiplatelet use was associated with lower presenting stroke severity (median NIHSS 4.5 vs 7, p=0.005) and increased likelihood of good discharge outcome (OR 2.105, p=0.0073).