Key result
Dual-antiplatelet therapy was superior to alteplase for achieving a favorable functional outcome at 3 months in acute minor ischemic stroke (OR 4.463; 95% CI 1.708-11.662; p=0.002).
Why the study?
The optimal treatment for acute ischemic stroke presenting with mild neurologic deficits remains unclear.
Does intravenous alteplase improve functional outcomes compared to dual-antiplatelet therapy in patients with acute minor ischemic stroke?
Comparison
Intravenous alteplase vs dual-antiplatelet therapy
Design
Retrospective cohort study
Follow-up
90 days
Authors
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DAPT associated with better outcomes than alteplase in minor stroke; hypothesis-generating and should not change practice without RCTs.
Cohort (n=228)
Does intravenous alteplase improve functional outcomes compared to dual-antiplatelet therapy in patients with acute minor ischemic stroke?
Odds Ratio: 4.463 (95% CI 1.708–11.662)
Absolute Event Rate: 91.6% vs 78%
p-value: p=0.002
In patients with acute minor ischemic stroke, dual-antiplatelet therapy with aspirin and clopidogrel was associated with better functional outcomes at 90 days and lower rates of asymptomatic intracranial hemorrhage compared to intravenous alteplase.
Lan et al. (2020) conducted a cohort in Acute minor ischemic stroke (n=228). Dual-antiplatelet therapy (aspirin plus clopidogrel) vs. Intravenous alteplase was evaluated on Modified Rankin Scale (mRS) score of 0 or 1 at 90 days (OR 4.463, 95% CI 1.708-11.662, p=0.002). Dual-antiplatelet therapy was superior to alteplase for achieving a favorable functional outcome at 3 months in acute minor ischemic stroke (OR 4.463; 95% CI 1.708-11.662; p=0.002).
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