Association of Antiplatelet Therapy With Lower Risk of Death and Recurrent Cerebrovascular Events After Ischemic Stroke: Results From the China Ischemic Stroke Registry Study

• Published in: Circulation Journal 2009, Vol.73(12), pp.2342-2347
• Main Authors: Ding, Ding, Lu, Chuan-Zhen, Fu, Jian-Hui, Hong, Zhen, The China Ischemic Stroke Registry Study (CISRS) investigators
• Format: Article
• Language: English
• Subjects: Aged; All-cause mortality; Antiplatelet therapy; Asian Continental Ancestry Group - statistics & numerical data; Brain Ischemia - complications; Brain Ischemia - drug therapy; Brain Ischemia - ethnology; Brain Ischemia - mortality; Cause of Death; Cerebrovascular events; China; China - epidemiology; Disability Evaluation; Female; Humans; Ischemic stroke; Kaplan-Meier Estimate; Male; Middle Aged; Platelet Aggregation Inhibitors - therapeutic use; Proportional Hazards Models; Prospective Studies; Registries; Risk Assessment; Risk Factors; Secondary Prevention; Severity of Illness Index; Stroke - drug therapy; Stroke - ethnology; Stroke - etiology; Stroke - mortality; Time Factors
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-09-0337

Background: Evidence of the beneficial effects of antiplatelet therapy after ischemic stroke is currently lacking in China. Methods and Results: Demographic data, pre-stroke risk factors, severity of neurological deficit, and disability graded by the National Institutes of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS) of 1,951 patients were measured and recorded at baseline. Regular follow-up by interview was performed for 12 months post-recruitment. The all-cause mortality was 1.88 per 100 person-years during the follow-up period. Recurrent fatal and nonfatal cerebrovascular events occurred in 90 patients, accounting for 4.24 per 100 person-years of cumulative incidence. After adjustment by other variables, antiplatelet therapy was identified as an independent protective predictor of all-cause death (hazard ratio (HR) 0.42; 95% confidence interval (CI) 0.21-0.86; P=0.017) and recurrent cerebrovascular events (HR 0.58; 95%CI 0.36-0.92; P=0.021). Among survivors, antiplatelet therapy was also an independent predictor for improvement in the NIHSS (HR 1.27; 95%CI 1.07-1.51; P=0.006) and the MRS (HR 1.25; 95%CI 1.02-1.52; P=0.031). Conclusions: The data from this multicenter, prospective study confirmed the association between antiplatelet therapy and decreased risk of all-cause mortality and recurrent cerebrovascular events after ischemic stroke in Chinese patients. (Circ J 2009; 73: 2342-2347)