Abstract:
:Recurrent stroke is common immediately following a transient ischemic attack (TIA) or ischemic stroke. Dual antiplatelet therapy (DAPT) with clopidogrel and aspirin may provide greater protection against subsequent stroke than monotherapy. Electronic databases were searched for randomized clinical trials (RCTs) comparing DAPT with monotherapy in ischemic stroke/TIA. Sixteen RCTs with a total of 29,032 patients were included. Compared with monotherapy, DAPT was associated with significantly lower rates of any stroke (risk ratio [RR] 0.80; 95% confidence interval [CI] 0.72-0.89) and ischemic stroke (RR 0.75; 95% CI 0.66-0.85) during any follow-up period. Although significant increases in intracranial bleeding (RR 1.55; 95% CI 1.20-2.01) and major bleeding (RR 1.90; 95% CI 1.33-2.72) were associated with DAPT, especially with long-term follow-up, the number needed to harm was 258 and 113, respectively. Nevertheless, short-duration DAPT (≤ 1 month) started during the early acute ischemic phase was associated with less bleeding than longer DAPT and greater reduction of recurrent strokes compared with monotherapy. In contrast, long DAPT and DAPT started later after the index event (≥ 1 month) were associated with similar rates of any stroke and increased risks of bleeding compared with monotherapy. Other clinical outcomes were essentially similar between the two groups and included recurrent TIA (RR 0.88; 95% CI 0.72-1.07), myocardial infarction (RR 1.04; 95% CI 0.84-1.29), vascular death (RR 0.99; 95% CI 0.82-1.19), and any death (RR 1.12; 95% CI 0.88-1.42). Similar findings were observed in patients who presented with minor stroke/TIA. Conclusions: Among patients who presented with ischemic stroke/TIA, short-course clopidogrel plus aspirin immediately following the index event appears to be more effective than and as safe as monotherapy for secondary stroke prevention.
journal_name
J Thromb Thrombolysisjournal_title
Journal of thrombosis and thrombolysisauthors
Kheiri B,Osman M,Abdalla A,Haykal T,Swaid B,Ahmed S,Chahine A,Hassan M,Bachuwa G,Al Qasmi M,Bhatt DLdoi
10.1007/s11239-018-1786-zsubject
Has Abstractpub_date
2019-02-01 00:00:00pages
233-247issue
2eissn
0929-5305issn
1573-742Xpii
10.1007/s11239-018-1786-zjournal_volume
47pub_type
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章,多中心研究
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
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abstract:OBJECTIVE:To report our experience with use of thrombolysis with streptokinase during cardiopulmonary resuscitation of patients with cardiac arrest due to myocardial infarction. DESIGN:A case series. METHODS:Thrombolytic therapy (streptokinase) was administered during cardiopulmonary resuscitation of 4 patients with ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-005-3547-z
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/BF01063156
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
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pub_type: 杂志文章
doi:10.1007/s11239-020-02084-w
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,多中心研究,随机对照试验
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1023/A:1008834230015
更新日期:1998-05-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-008-0239-5
更新日期:2009-07-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-020-02220-6
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11239-019-01823-y
更新日期:2019-04-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-005-0942-4
更新日期:2005-02-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/BF01064375
更新日期:1995-01-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
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doi:10.1007/s11239-018-1701-7
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
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更新日期:1999-10-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章,评审
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-017-1590-1
更新日期:2018-02-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-018-1788-x
更新日期:2019-04-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-017-1477-1
更新日期:2017-05-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 临床试验,杂志文章
doi:10.1007/s11239-012-0758-y
更新日期:2012-11-01 00:00:00
abstract::We have applied the low molecular weight heparin dalteparin as once-daily subcutaneous injections to the treatment of deep vein thrombosis (DVT) on an outpatient basis since 1994. Until today, 377 consecutive patients with DVT below the inguinal ligament have been treated at home with dalteparin. The patients administ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1023/A:1008866025015
更新日期:1998-09-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-007-0181-y
更新日期:2009-02-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-015-1269-4
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:The endothelial ADP receptor P2Y(1) is responsible for a large part of the reactive hyperemia following cardiac ischemia. Tissue plasminogen activator (t-PA) increases during reactive hyperemia. We postulated that the release of t-PA during reactive hyperemia could be mitigated through blocking the coronary ...
journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-007-0010-3
更新日期:2007-10-01 00:00:00
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journal_title:Journal of thrombosis and thrombolysis
pub_type: 杂志文章
doi:10.1007/s11239-019-01914-w
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