Effect of Dual Antiplatelet Therapy on Hospital Outcomes in Minor Stroke Patients with Different Baseline Blood Pressure
LI Yali
LIU Tingting
WANG Yongle
LI Yanan
ZHANG Kaili
FAN Haimei
LI Juan
REN Jing
LI Xinyi
WU Xuemei
NIU Xiaoyuan
Abstract：Objective:To observe the effect of dual antiplatelet therapy on hospital outcomes in minor stroke patients with different baseline blood pressure.Methods:Minor stroke patients with National Institutes of Health Stroke Scale(NIHSS)score≤5 were included.The patients were divided into aspirin monotherapy(AM)group,dual antiplatelet therapy of aspirin plus loading dose clopidogrel(DAPT-ALC,clopidogrel loading dose 300 mg at the first day)group,and dual antiplatelet therapy of aspirin plus unloading dose clopidogrel(DAPT-AUC,clopidogrel 75 mg at the first day)group.The patients were divided into to systolic blood pressure(＜140 mmHg,140～＜180 mmHg,and≥180 mmHg)subgroup and diastolic blood pressure(＜90 mmHg,90～＜110 mmHg,and≥110 mmHg)subgroup based on blood pressure records at admission.Comparisons of continuous variables between multiple groups were performed by one-way analysis of variance,and comparisons of categorical variables were performed by the χ2 test or Fishers exact probability method.Logistic model fitting was used to analyze in-hospital outcomes.Results:A total of 1 312 patients were included.Compared with AM group,patients in DAPT-ALC group were younger,admitted earlier,with higher rates of smoking history,coronary heart disease history,myocardial infarction history,intracranial artery stenosis,and statin use at onset(P＜0.05).Compared with AM group,the patients in DAPT-AUC group were younger,with higher systolic blood pressure at admission,and showed a higher proportion without history of cerebral hemorrhage(P＜0.05).After adjusting for confounding factors,DAPT-ALC group showed decreased incidence of compound stroke events in hospital compared with that of AM group.Compared with the AM group,patients with systolic blood pressure＜140 mmHg at admission could be benefited from DAPT-ALC.Compared with the AM group,patients with systolic blood pressure≥180 mmHg at admission could be benefited from DAPT-AUC.Compared with the AM group,patients with diastolic blood pressure of 90～＜110 mmHg at admission could be benefited from DAPT-ALC.Conclusion:Different doses of antiplatelet therapy had different in-hospital outcomes benefits for minor stroke based on different baseline blood pressure,suggesting that in clinical practice,individualized antiplatelet therapy treatment decisions showed a significant impact on patient outcomes.
Keywords：minor strokebaseline blood pressuredual antiplatelet therapyhospital outcomes
Publication Date：2025-01-31
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：11( 197-207 )