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Non-persistence with anti-platelet therapy and long-term mortality after ischemic stroke: A nationwide study

PLoS Neglected Tropical Diseases Feb 12, 2021

Kim SJ, Kwon OD, Choi HC, et al. - Researchers conducted the study for analyzing the impact on long-term all-cause mortality of non-persistence with antiplatelets following ischemic stroke. Newly diagnosed ischemic stroke patients aged ≥ 20 years were selected who were newly treated with aspirin or clopidogrel from 2003–2010 in the Korean National Health Insurance Service-National Sample Cohort, a random sample of 2.2% of the total population. Participants were divided by persistence with antiplatelets at 6 and 12 months into two pairs of groups: those who stopped antiplatelets within 6 months (DA6M) and those who continued them for 6 or months or more (CA6M); and those who stopped antiplatelets within 12 months (DA12M) and those who continued them for 12 months or more (CA12M). Among 3,559 total individuals, DA6M were 1,080 and CA6M were 2,479 while, out of 3,628 total patients, DA12M were 1,434 and CA12M were 2,194. Maintaining antiplatelets after ischemic stroke for the first 12 months lowers the long-term risk of both CVD death and non-CVD death. Compared to CA6M , the risks of ACM, cerebro-cardiovascular disease (CVD) death, and non-CVD death were all significantly increased in DA6M. While aHRs were lower than that between DA6M and CA6M, DA12M also had significantly greater risks of ACM, CVD mortality and non-CVD mortality vs DA12M. Though the degree of difference gradually decreased, the difference rates of ACM, CVD death, and non-CVD death between non-persistent and persistent groups all continuously widened over time.

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