Research
Print page Print page
Switch language
Rigshospitalet - a part of Copenhagen University Hospital
Published

Comparison of Antiplatelet Therapies for Prevention of Patent Foramen Ovale-Associated Stroke

Research output: Contribution to journalJournal articleResearchpeer-review

  1. Workforce Attachment after Ischemic Stroke – The Importance of Time to Thrombolytic Therapy

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Nursing Home Admission and Initiation of Domiciliary Care After Ischemic Stroke – The Importance of Time to Thrombolysis

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Spontaneous Subarachnoid Haemorrhage as a Cause of Out-of-Hospital Death

    Research output: Contribution to journalJournal articleResearchpeer-review

  4. Associations between serum L-arginine and ficolins in the early phase of acute ischemic stroke - A pilot study

    Research output: Contribution to journalJournal articleResearchpeer-review

  5. Self-Reported Physical Activity and Cardiovascular Disease Risk Factors in Patients with Lacunar Stroke

    Research output: Contribution to journalJournal articleResearchpeer-review

  1. Temporal trends in utilization of transcatheter aortic valve replacement and patient characteristics: a nationwide study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Incidence of Infective Endocarditis Among Patients With Tetralogy of Fallot

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. Workforce Attachment after Ischemic Stroke – The Importance of Time to Thrombolytic Therapy

    Research output: Contribution to journalJournal articleResearchpeer-review

View graph of relations

AIMS: The REDUCE study demonstrated a reduction in the risk of recurrent stroke with patent foramen ovale closure and antiplatelet therapy compared to antiplatelet therapy alone. The clinicians were allowed to choose among aspirin, clopidogrel, or aspirin/dipyridamole with the expectation that all antiplatelet therapies would have similar efficacy in this population. We tested that presumption by comparing recurrent stroke rates among antiplatelet agents within the control arm of the trial.

METHODS: We evaluated patients in REDUCE study who were randomized to the medical arm. The primary endpoint for this analysis was freedom from clinical ischemic stroke through at least 2 years of follow-up, to a maximum of 5 years. In the primary analysis, antiplatelet treatment was defined as the agent during the week prior to a recurrent stroke or last known contact.

RESULTS: Of 223 patients in the medical treatment arm, the initial agent was aspirin 52%, clopidogrel 30%, and aspirin/dipyridamole 12%. Patients treated with aspirin were similar to those treated with alternatives, but were more likely to be enrolled in the United States. The last reported agent was aspirin alone in 55%, clopidogrel alone in 31%, aspirin/dipyridamole in 7%, and other/nothing/missing in 7%. Recurrent stroke rates were similar for all 3 antiplatelet regimens in unadjusted and adjusted analyses, with no overall difference among agents (P= .17).

CONCLUSIONS: Among patients with patent foramen ovale-associated stroke who were managed medically, there were no differences among antiplatelet agents in the risk of recurrent stroke, though confidence intervals were wide.

Original languageEnglish
JournalJournal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
Volume29
Issue number4
Pages (from-to)104632
ISSN1052-3057
DOIs
Publication statusPublished - Apr 2020

    Research areas

  • Adolescent, Adult, Aspirin/adverse effects, Clopidogrel/administration & dosage, Dipyridamole/administration & dosage, Drug Therapy, Combination, Female, Foramen Ovale, Patent/complications, Humans, Male, Middle Aged, Platelet Aggregation Inhibitors/adverse effects, Progression-Free Survival, Prospective Studies, Recurrence, Risk Factors, Secondary Prevention, Stroke/diagnosis, Time Factors, Young Adult

ID: 62085760