| アブストラクト | BACKGROUND: Dual antiplatelet therapy (DAPT) is more effective than aspirin alone in preventing early recurrences of non-cardioembolic strokes. In Japan, DAPT is often combined with argatroban, a direct thrombin inhibitor, for treating acute atherosclerotic stroke. However, the safety and effectiveness of this combination compared with those of DAPT alone remains unclear. METHODS: We identified patients with acute atherothrombotic stroke treated with DAPT between April 2016 and March 2022, using the Diagnostic Procedure Combination database, a large national inpatient database in Japan. Patients were divided into two groups: those receiving DAPT plus argatroban and those receiving DAPT alone. We compared 7-day mortality, hemorrhagic complications, and readmission for stroke recurrence within 90 days between the groups using propensity-score overlap weighting analyses. RESULTS: Of 59,983 eligible patients, 47,213 received DAPT plus argatroban, while 12,770 received DAPT alone. In the propensity-score overlap weighting analyses, no significant differences in 7-day mortality (0.2% vs 0.2%; adjusted risk ratio [aRR], 0.77; 95% confidence interval [CI], 0.49-1.21), the proportions of hemorrhagic complications (2.3% vs 2.1%; aRR, 1.12; 95% CI, 0.99-1.27), or 90-day readmission for stroke recurrence (1.2% vs 1.2%; aRR, 0.99; 95%CI, 0.84-1.17) were observed between the DAPT plus argatroban and DAPT alone groups. CONCLUSIONS: The outcomes did not differ significantly between DAPT alone and argatroban combined with DAPT for acute atherothrombotic stroke. |
|---|
| ジャーナル名 | International journal of stroke : official journal of the International Stroke Society |
|---|
| Pubmed追加日 | 2025/5/16 |
|---|
| 投稿者 | Nakashima, Saki; Kodama, Satoshi; Aso, Shotaro; Jo, Taisuke; Yasunaga, Hideo; Isogai, Toshiaki; Matsui, Hiroki; Shirota, Yuichiro; Fushimi, Kiyohide; Toda, Tatsushi; Hamada, Masashi |
|---|
| 組織名 | Department of Neurology, Graduate School of Medicine, The University of Tokyo,;Tokyo, Japan.;Department of Health Services Research, Graduate School of Medicine, The;University of Tokyo, Tokyo, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public;Health, The University of Tokyo, Tokyo, Japan.;Department of Cardiology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan.;Department of Clinical Laboratory Medicine, Graduate School of Medicine, The;Department of Health Policy and Informatics, Institute of Science Tokyo Graduate;School, Tokyo, Japan. |
|---|
| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40375365/ |
|---|
