Dual antiplatelet therapy (DAPT) reduced the risk of ischemic stroke irrespective of premorbid antiplatelet use in patients with minor stroke and high-risk transient ischemic attack (TIA), according to new data published in Stroke.
Data was from the POINT (Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke) trial.
Fifty-four percent of the patients were men, and the mean patient age was 66.3 years old.
The primary outcome was ischemic stroke during the 90-day follow-up, while the secondary outcome was the risk of major bleeding, hospitalization or prolongation of an existing hospitalization, or death attributable to hemorrhaging.
The study included 4,881 patients of which 41% belonged to the no pretreatment antiplatelet group.
In the analysis, ischemic stroke outcomes happened in 6% in the antiplatelet pretreatment group and 5% in the no antiplatelet pretreatment group.
The authors found that antiplatelet pretreatment was not linked with the risk of ischemic stroke or major hemorrhage.
In addition, the impact of dual antiplatelet therapy on recurrent ischemic stroke risk was not dissimilar in patients who were on antiplatelet prior to randomization compared with patients who were not.
“In this study, we found that pretreatment antiplatelet therapy was not associated with the risk of recurrent ischemic stroke,” wrote Mohammad Anadani, MD, with the department of neurology, Washington University, Saint Louis, Missouri. “More importantly, the effect of DAPT appeared to be consistent regardless of pretreatment antiplatelet therapy. Our study adds additional evidence that patients with minor stroke or TIA should be started on DAPT irrespective of their pretreatment antiplatelet status.”
The authors noted that the study did have limitations. For example, imbalances between the antiplatelet pretreatment and no antiplatelet pretreatment groups could have had an impact on the results in an unpredictable manner despite adjustments for possible confounders.
Read the full study here.