Antiplatelet therapy increases symptomatic ICH risk after thrombolysis and thrombectomy.
Acta Neurol Scand. 2021-05-27; 144(5): 500-508
DOI: 10.1111/ane.13468
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Couture M(1), Marnat G(2), Griffier R(3), Gariel F(2), Olindo S(1), Renou P(1),Sagnier S(1)(4), Berge J(2), Tourdias T(2)(5), Sibon I(1)(4)(6).
Author information:
(1)CHU de Bordeaux, Unité Neuro-vasculaire, Bordeaux, France.
(2)CHU de Bordeaux, Neuroimagerie diagnostique et thérapeutique, Bordeaux,
France.
(3)CHU de Bordeaux, Pôle de Santé Publique, Service d’information médicale,
Bordeaux, France.
(4)UMR 5287 CNRS, Université de Bordeaux, EPHE PSL Research University,
Bordeaux, France.
(5)INSERM-U1215, Neurocentre Magendie, Bordeaux, France.
(6)Université de Bordeaux, Bordeaux, France.
BACKGROUND AND PURPOSE: The influence of chronic treatment by antiplatelet drug
(APD) at stroke onset on the outcomes of patients with acute ischemic stroke
(AIS) treated with combined intravenous thrombolysis (IVT) and endovascular
therapy (EVT) is unclear. We investigated whether prior APD use influences the
risk of symptomatic intracranial hemorrhage (sICH) and functional outcome in AIS
patients treated with combined reperfusion therapy.
METHODS: A single-center retrospective analysis of AIS patients with proximal
intracranial occlusion who underwent IVT and EVT between January 2015 and May
2017. The main outcomes were the incidence of sICH using the Heidelberg Bleeding
Classification and patients’ functional status at 90 days, as defined by the
modified Rankin scale (mRS). Outcomes were evaluated according to daily exposure
to APD, and associations were assessed using multivariate logistic regression
analysis.
RESULTS: This study included 204 patients: 71 (34.8%) were taking APD before
AIS. Patients with chronic treatment by APD at stroke onset had a higher rate of
sICH (26.7% vs. 3.7%; p2) at 90 days
(69% vs. 36.8%; p