NIHSS and Large Artery Atherosclerosis Affect Efficacy of Dual Antiplatelet Therapy Versus Alteplase for Minor Stroke.
Yu Cui, Zi-Ang Li, Chao He et al.
✦ AI-curated · Sources linked
In 30 seconds
This randomized controlled trial analyzed the efficacy of dual antiplatelet therapy (DAPT) versus alteplase in patients with minor stroke (NIHSS 0-5) and assessed the impact of large artery atherosclerosis (LAA). Among 478 patients, those with NIHSS 0-3 and LAA showed a numerically higher rate of excellent functional outcomes with DAPT (97.3% vs. 85.1%; adjusted OR, 6.45), although not statistically significant. The findings suggest that neurological deficit and LAA may influence treatment efficacy.
Key findings
- In NIHSS 0-3 with LAA, DAPT showed a numerically higher rate of excellent outcomes (97.3% vs. 85.1%; adjusted OR, 6.45).
- In NIHSS 0-3 with Non-LAA, outcomes were similar between DAPT and alteplase (96.5% vs. 94.4%; adjusted OR, 1.67).
- DAPT significantly increased the likelihood of excellent outcomes in NIHSS 0-3 with LAA (adjusted OR, 6.49; p = 0.01).
- Safety outcomes were comparable across DAPT and alteplase treatments.
Why it matters
Understanding the differential efficacy of DAPT versus alteplase in minor strokes, particularly in the context of LAA, can guide treatment decisions and optimize patient outcomes in this population.
What to keep in mind
The study's exploratory nature and lack of formal adjustment for multiple comparisons limit the strength of the conclusions.