Key result
Dual antiplatelet therapy linked to ~52% lower stroke recurrence in overweight patients with low glycated albumin.
Why the study?
A single index of BMI may not fully address its impact on anti-platelet therapy efficacy in minor stroke or TIA patients.
Does clopidogrel-aspirin therapy reduce stroke recurrence in patients with minor stroke or transient ischemic attack when stratified by BMI and glycemic control?
Cohort
Does clopidogrel-aspirin therapy reduce stroke recurrence in patients with minor stroke or transient ischemic attack when stratified by BMI and glycemic control?
The efficacy of dual antiplatelet therapy with clopidogrel and aspirin for secondary stroke prevention is attenuated in patients with concurrent overweight/obesity and poor glycemic control.
BACKGROUND: A single index of body mass index (BMI) may not fully address its impact on anti-platelet therapy. We aimed to elucidate the combined impact of BMI and dysglycemia expressed by glycated albumin (GA) on efficacy of clopidogrel-aspirin therapy among minor stroke (MS) or transient ischemic attack (TIA) patients. RESULTS: Patients with overweight/obesity and low GA levels still benefited from clopidogrel-aspirin therapy for stroke recurrence (Hazard ratio [HR]: 0.48, 95 % confidence interval [CI]: 0.28-0.82), so did those with high GA levels but low/normal weight (HR: 0.67, 95 % CI: 0.45-0.99). However, patients with both overweight/obesity and high GA levels did not benefit from clopidogrel-aspirin therapy (HR: 0.89, 95 % CI: 0.59-1.33). CONCLUSIONS: Compared with aspirin alone, efficacy of clopidogrel-aspirin therapy for stroke still exists in overweight/obesity patients with normal glycemic control. Elevated and low GA levels were defined as GA levels > 15.5 % and ≤ 15.5 %, respectively. The primary outcome was stroke recurrence during the 90-day follow-up.
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Chen et al. (2020) conducted a cohort in Minor stroke or transient ischemic attack. Clopidogrel-aspirin therapy vs. Aspirin alone was evaluated on Stroke recurrence (HR 0.48, 95% CI 0.28-0.82). Clopidogrel-aspirin therapy reduced stroke recurrence compared to aspirin alone in overweight or obese patients with low glycated albumin levels (HR 0.48; 95% CI 0.28-0.82).
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