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ABSTRACT: Background
In real-world practice settings, there is insufficient evidence on the efficacy of antiplatelet drugs, including clopidogrel, aspirin, and ticlopidine, in stroke prevention.Purpose
To compare the efficacies between aspirin and clopidogrel and aspirin and ticlopidine in stroke prevention.Methods
This population-based case-cohort study utilized the data obtained from a randomized sample of one million subjects in the Taiwan National Health Insurance Research Database. Patients who were hospitalized owing to the primary diagnosis of ischemic stroke from January 1, 2000 to December 31, 2010 and treated with aspirin, ticlopidine, or clopidogrel were included in the study. Propensity score matching with a 1:4 ratio was performed to compare aspirin with ticlopidine and clopidogrel. The criteria for inclusion were the use of one of the three antiplatelet drugs for more than 14 days within the first month after the stroke and then continued use of the antiplatelet drugs until the study endpoint of recurrent stroke.Results
During the 3-year follow-up period, the recurrent stroke rates were 1.62% (42/2585), 1.48% (3/203), and 2.55% (8/314) in the aspirin, ticlopidine, and clopidogrel groups, respectively. Compared with the patients treated with aspirin, those treated with clopidogrel and ticlopidine showed competing risk-adjusted hazard ratios of recurrent stroke of 2.27 (1.02-5.07) and 0.62 (0.08-4.86), respectively.Conclusion
Compared with the patients treated with aspirin, those treated with clopidogrel were at a higher risk of recurrent stroke. For stroke prevention, aspirin was superior to clopidogrel whereas ticlopidine was not inferior to aspirin.
SUBMITTER: Wong YS
PROVIDER: S-EPMC7769270 | biostudies-literature | 2020
REPOSITORIES: biostudies-literature
Wong Yi-Sin YS Tsai Ching-Fang CF Hsu Yueh-Han YH Ong Cheung-Ter CT
PloS one 20201228 12
<h4>Background</h4>In real-world practice settings, there is insufficient evidence on the efficacy of antiplatelet drugs, including clopidogrel, aspirin, and ticlopidine, in stroke prevention.<h4>Purpose</h4>To compare the efficacies between aspirin and clopidogrel and aspirin and ticlopidine in stroke prevention.<h4>Methods</h4>This population-based case-cohort study utilized the data obtained from a randomized sample of one million subjects in the Taiwan National Health Insurance Research Data ...[more]