TY - JOUR T1 - Comparative effectiveness of combined antiplatelet treatments in acute minor ischaemic stroke JF - Stroke and Vascular Neurology JO - Stroke Vasc Neurol DO - 10.1136/svn-2020-000841 SP - svn-2020-000841 AU - Shina Kim AU - Joon-Tae Kim AU - Ji Sung Lee AU - Beom Joon Kim AU - Jong-Moo Park AU - Kyusik Kang AU - Soo Joo Lee AU - Jae Guk Kim AU - Jae-Kwan Cha AU - Dae-Hyun Kim AU - Tai Hwan Park AU - Sang-Soon Park AU - Kyung Bok Lee AU - Jun Lee AU - Keun-Sik Hong AU - Yong-Jin Cho AU - Hong-Kyun Park AU - Byung-Chul Lee AU - Kyung-Ho Yu AU - Mi Sun Oh AU - Dong-Eog Kim AU - Wi-Sun Ryu AU - Jay Chol Choi AU - Jee-Hyun Kwon AU - Wook-Joo Kim AU - Dong-Ick Shin AU - Sung-Il Sohn AU - Jeong-Ho Hong AU - Man-Seok Park AU - Kang-Ho Choi AU - Ki-Hyun Cho AU - Juneyoung Lee AU - Hee-Joon Bae Y1 - 2021/07/20 UR - http://svn.bmj.com/content/early/2021/07/20/svn-2020-000841.abstract N2 - Background No study has thoroughly compared the effectiveness of combined antiplatelet treatments (other than clopidogrel–aspirin) versus clopidogrel–aspirin or aspirin alone for early secondary prevention in acute ischaemic stroke.Methods We identified patients with acute, minor, non-cardiogenic ischaemic stroke treated with aspirin alone, clopidogrel–aspirin or other combination treatment. Propensity scores considering the inverse probability of treatment weighting were used to adjust for baseline imbalances. The primary outcome was the composite of all strokes (ischaemic or haemorrhagic), myocardial infarction and all-cause mortality at 3 months.Results Among 12 234 patients (male: 61.9%; age: 65.5±13 years) who met the eligibility criteria, aspirin, clopidogrel–aspirin and other combination treatments were administered in 52.2%, 42.9% and 4.9% of patients, respectively. In the crude analysis, the primary outcome event at 3 months occurred in 14.5% of the other combination group, 14.4% of the aspirin group and 13.0% of the clopidogrel–aspirin group. In the weighted Cox proportional hazards analysis, the 3-month primary outcome event occurred less frequently in the clopidogrel–aspirin group than in the other combination group (weighted HR: 0.82 (0.59–1.13)), while no association was found between the aspirin group (weighted HR: 1.04 (0.76–1.44)) or other combination group and the 3-month primary outcome.Conclusion Other combined antiplatelet treatment, compared with aspirin alone or clopidogrel–aspirin, was not associated with reduced risks of primary composite vascular events or recurrent stroke during the first 3 months after stroke. Therefore, the results suggest that other combination treatments, particularly the cilostazol-based combination, may not be effective alternatives for clopidogrel–aspirin to prevent early vascular events in patients with acute minor stroke. Further exploration in clinical trials will be needed.Data are available upon reasonable request. The CRCS-K research committee will provide the data, analytic methods and study materials to other researchers upon reasonable request. ER -