Outcomes of dual antiplatelet therapy in ischemic stroke or transient ischemic attack patients with tandem carotid artery stenosis or carotid artery occlusion
Keywords:
carotid artery occlusion, dual antiplatelet, stroke, tandem carotid artery stenosisAbstract
Background and objective: Carotid artery stenosis is one of the causes of ischemic stroke. However, some ischemic stroke or transient ischemic attack patients with carotid artery stenosis cannot be performed carotid endarterectomy due to the characteristic of carotid artery lesion. Dual antiplatelet therapy was shown to reduce the rate of recurrence of ischemic stroke. The objective of this study was to determine the outcomes of dual antiplatelet therapy in ischemic stroke or transient ischemic attack patients with tandem carotid artery stenosis or occlusion.
Materials and Methods: This retrospective cohort study examined the clinical, imaging data and clinical outcomes of ischemic stroke or transient ischemic attack patients with tandem carotid artery stenosis or occlusion. Univariate analysis and multiple logistic regression model of included relevant confounders and potential predictors were performed.
Results: Patients who received single antiplatelet therapy had higher risk of recurrent ischemic stroke or transient ischemic attack than patients who received dual antiplatelet therapy at 12-months follow-up (odd ratio (OR), 0.67; confidence interval (95%CI), 0.26-0.98; p=0.029) but not significance in number of death (OR, 0.86; 95%CI, 0.32-39.49; p=0.556). The rate of extracranial bleeding events was higher in dual antiplatelet group than in single antiplatelet group (10.7% versus 5.3% (OR, 3.33; 95%CI, 1.88-5.80; p=<0.001)).
Conclusion: Ischemic stroke or transient ischemic attack patients with tandem carotid artery stenosis or occlusion have potential clinical benefit from dual antiplatelet therapy with increase in the risk of minor extracranial bleeding.
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