Safety and Efficacy of Baseline Antiplatelet Treatment in
Patients Undergoing Mechanical Thrombectomy for Ischemic
Stroke: Antiplatelets Before Mechanical Thrombectomy

J 2023

Safety and Efficacy of Baseline Antiplatelet Treatment in Patients Undergoing Mechanical Thrombectomy for Ischemic Stroke: Antiplatelets Before Mechanical Thrombectomy

KLAIL, Tomáš, Petra ŠEDOVÁ, Jan VINKLÁREK, Ingrid KOVACOVA, Michal BAR et. al.

Basic information

Original name

Safety and Efficacy of Baseline Antiplatelet Treatment in Patients Undergoing Mechanical Thrombectomy for Ischemic Stroke: Antiplatelets Before Mechanical Thrombectomy

Authors

KLAIL, Tomáš (203 Czech Republic, belonging to the institution), Petra ŠEDOVÁ (203 Czech Republic, belonging to the institution), Jan VINKLÁREK (203 Czech Republic, belonging to the institution), Ingrid KOVACOVA (203 Czech Republic), Michal BAR (203 Czech Republic), Filip CIHLAR (203 Czech Republic), David CERNIK (203 Czech Republic), Lubomir KOCI (203 Czech Republic), René JURA (203 Czech Republic, belonging to the institution), Roman HERZIG (203 Czech Republic), Jakub HUSTÝ (203 Czech Republic, belonging to the institution), Martin KOCHER (203 Czech Republic), Martin KOVAR (203 Czech Republic), Miroslava NEVSIMALOVA (203 Czech Republic), Jan RAUPACH (203 Czech Republic), Miloslav ROCEK (203 Czech Republic), Daniel SANAK (203 Czech Republic), Petr SEVCIK (203 Czech Republic), David SKOLOUDIK (203 Czech Republic), Martin SRAMEK (203 Czech Republic), Jiří VANÍČEK (203 Czech Republic, belonging to the institution), Peter VASKO (203 Czech Republic), Daniel VACLAVIK (203 Czech Republic), Ales TOMEK (203 Czech Republic) and Robert MIKULÍK (203 Czech Republic, guarantor, belonging to the institution)

Edition

Journal of vascular and interventional radiology, New York, ELSEVIER, 2023, 1051-0443

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30210 Clinical neurology

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 2.900 in 2022

RIV identification code

RIV/00216224:14110/23:00131949

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.jvir.2023.05.017

UT WoS

001068364800001

Keywords (in Czech)

THERAPYTHROMBOLYSISMETAANALYSISGUIDELINESOUTCOMES

Keywords in English

THERAPYTHROMBOLYSISMETAANALYSISGUIDELINESOUTCOMES

Abstract

V originále

Purpose: To investigate the safety and efficacy of baseline antiplatelet treatment in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT). Materials and Methods: Baseline use of antiplatelet medication before MT for (AIS) may provide benefit on reperfusion and clinical outcome but could also carry an increased risk of intracranial hemorrhage (ICH). All consecutive patients with AIS and treated with MT with and without intravenous thrombolysis (IVT) between January 2012 and December 2019 in all centers performing MT nationwide were reviewed. Data were prospectively collected in national registries (eg, SITS-TBY and RES-Q). Primary outcome was functional independence (modified Rankin Scale 0-2) at 3 months; secondary outcome was ICH. Results: Of the 4,351 patients who underwent MT, 1,750 (40%) and 666 (15%) were excluded owing to missing data from the functional independence and ICH outcome cohorts, respectively. In the functional independence cohort (n = 2,601), 771 (30%) patients received antiplatelets before MT. Favorable outcome did not differ in any antiplatelet, aspirin, and clopidogrel groups when compared with that in the no-antiplatelet group: odds ratio (OR), 1.00 (95% CI, 0.84-1.20); OR, 1.05 (95% CI, 0.86-1.27); and OR, 0.88 (95% CI, 0.55-1.41), respectively. In the ICH cohort (n = 3,685), 1095 (30%) patients received antiplatelets before MT. The rates of ICH did not increase in any treatment options (any antiplatelet, aspirin, clopidogrel, and dual antiplatelet groups) when compared with those in the no-antiplatelet group: OR, 1.03 (95% CI, 0.87-1.21); OR, 0.99 (95% CI, 0.83-1.18); OR, 1.10 (95% CI, 0.82-1.47); and OR, 1.43 (95% CI, 0.87-2.33), respectively. Conclusions: Antiplatelet monotherapy before MT did not improve functional independence or increase the risk of ICH.

Links

90249, large research infrastructures

Name: CZECRIN IV

Citovat

KLAIL, Tomáš, Petra ŠEDOVÁ, Jan VINKLÁREK, Ingrid KOVACOVA, Michal BAR, Filip CIHLAR, David CERNIK, Lubomir KOCI, René JURA, Roman HERZIG, Jakub HUSTÝ, Martin KOCHER, Martin KOVAR, Miroslava NEVSIMALOVA, Jan RAUPACH, Miloslav ROCEK, Daniel SANAK, Petr SEVCIK, David SKOLOUDIK, Martin SRAMEK, Jiří VANÍČEK, Peter VASKO, Daniel VACLAVIK, Ales TOMEK and Robert MIKULÍK. Safety and Efficacy of Baseline Antiplatelet Treatment in Patients Undergoing Mechanical Thrombectomy for Ischemic Stroke: Antiplatelets Before Mechanical Thrombectomy. Journal of vascular and interventional radiology. New York: ELSEVIER, 2023, vol. 34, No 9, p. "1502"-"1512.e12", 21 pp. ISSN 1051-0443. Available from: https://dx.doi.org/10.1016/j.jvir.2023.05.017.

@article{2327097,
   author = {Klail, Tomáš and Šedová, Petra and Vinklárek, Jan and Kovacova, Ingrid and Bar, Michal and Cihlar, Filip and Cernik, David and Koci, Lubomir and Jura, René and Herzig, Roman and Hustý, Jakub and Kocher, Martin and Kovar, Martin and Nevsimalova, Miroslava and Raupach, Jan and Rocek, Miloslav and Sanak, Daniel and Sevcik, Petr and Skoloudik, David and Sramek, Martin and Vaníček, Jiří and Vasko, Peter and Vaclavik, Daniel and Tomek, Ales and Mikulík, Robert},
   article_location = {New York},
   article_number = {9},
   doi = {http://dx.doi.org/10.1016/j.jvir.2023.05.017},
   keywords = {THERAPYTHROMBOLYSISMETAANALYSISGUIDELINESOUTCOMES},
   language = {eng},
   issn = {1051-0443},
   journal = {Journal of vascular and interventional radiology},
   title = {Safety and Efficacy of Baseline Antiplatelet Treatment in Patients Undergoing Mechanical Thrombectomy for Ischemic Stroke: Antiplatelets Before Mechanical Thrombectomy},
   url = {https://www.sciencedirect.com/science/article/pii/S1051044323003494?via%3Dihub},
   volume = {34},
   year = {2023}
}

TY  - JOUR
ID  - 2327097
AU  - Klail, Tomáš - Šedová, Petra - Vinklárek, Jan - Kovacova, Ingrid - Bar, Michal - Cihlar, Filip - Cernik, David - Koci, Lubomir - Jura, René - Herzig, Roman - Hustý, Jakub - Kocher, Martin - Kovar, Martin - Nevsimalova, Miroslava - Raupach, Jan - Rocek, Miloslav - Sanak, Daniel - Sevcik, Petr - Skoloudik, David - Sramek, Martin - Vaníček, Jiří - Vasko, Peter - Vaclavik, Daniel - Tomek, Ales - Mikulík, Robert
PY  - 2023
TI  - Safety and Efficacy of Baseline Antiplatelet Treatment in Patients Undergoing Mechanical Thrombectomy for Ischemic Stroke: Antiplatelets Before Mechanical Thrombectomy
JF  - Journal of vascular and interventional radiology
VL  - 34
IS  - 9
SP  - "1502"-"1512.e12"
EP  - "1502"-"1512.e12"
PB  - ELSEVIER
SN  - 10510443
KW  - THERAPYTHROMBOLYSISMETAANALYSISGUIDELINESOUTCOMES
UR  - https://www.sciencedirect.com/science/article/pii/S1051044323003494?via%3Dihub
N2  - Purpose: To investigate the safety and efficacy of baseline antiplatelet treatment in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT). Materials and Methods: Baseline use of antiplatelet medication before MT for (AIS) may provide benefit on reperfusion and clinical outcome but could also carry an increased risk of intracranial hemorrhage (ICH). All consecutive patients with AIS and treated with MT with and without intravenous thrombolysis (IVT) between January 2012 and December 2019 in all centers performing MT nationwide were reviewed. Data were prospectively collected in national registries (eg, SITS-TBY and RES-Q). Primary outcome was functional independence (modified Rankin Scale 0-2) at 3 months; secondary outcome was ICH. Results: Of the 4,351 patients who underwent MT, 1,750 (40%) and 666 (15%) were excluded owing to missing data from the functional independence and ICH outcome cohorts, respectively. In the functional independence cohort (n = 2,601), 771 (30%) patients received antiplatelets before MT. Favorable outcome did not differ in any antiplatelet, aspirin, and clopidogrel groups when compared with that in the no-antiplatelet group: odds ratio (OR), 1.00 (95% CI, 0.84-1.20); OR, 1.05 (95% CI, 0.86-1.27); and OR, 0.88 (95% CI, 0.55-1.41), respectively. In the ICH cohort (n = 3,685), 1095 (30%) patients received antiplatelets before MT. The rates of ICH did not increase in any treatment options (any antiplatelet, aspirin, clopidogrel, and dual antiplatelet groups) when compared with those in the no-antiplatelet group: OR, 1.03 (95% CI, 0.87-1.21); OR, 0.99 (95% CI, 0.83-1.18); OR, 1.10 (95% CI, 0.82-1.47); and OR, 1.43 (95% CI, 0.87-2.33), respectively. Conclusions: Antiplatelet monotherapy before MT did not improve functional independence or increase the risk of ICH.
ER  -

KLAIL, Tomáš, Petra ŠEDOVÁ, Jan VINKLÁREK, Ingrid KOVACOVA, Michal BAR, Filip CIHLAR, David CERNIK, Lubomir KOCI, René JURA, Roman HERZIG, Jakub HUSTÝ, Martin KOCHER, Martin KOVAR, Miroslava NEVSIMALOVA, Jan RAUPACH, Miloslav ROCEK, Daniel SANAK, Petr SEVCIK, David SKOLOUDIK, Martin SRAMEK, Jiří VANÍČEK, Peter VASKO, Daniel VACLAVIK, Ales TOMEK and Robert MIKULÍK. Safety and Efficacy of Baseline Antiplatelet Treatment in Patients Undergoing Mechanical Thrombectomy for Ischemic Stroke: Antiplatelets Before Mechanical Thrombectomy. \textit{Journal of vascular and interventional radiology}. New York: ELSEVIER, 2023, vol.~34, No~9, p.~''1502''-''1512.e12'', 21 pp. ISSN~1051-0443. Available from: https://dx.doi.org/10.1016/j.jvir.2023.05.017.

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