@article {Kim13, author = {Shina Kim and Joon-Tae Kim and Ji Sung Lee and Beom Joon Kim and Jong-Moo Park and Kyusik Kang and Soo Joo Lee and Jae Guk Kim and Jae-Kwan Cha and Dae-Hyun Kim and Tai Hwan Park and Sang-Soon Park and Kyung Bok Lee and Jun Lee and Keun-Sik Hong and Yong-Jin Cho and Hong-Kyun Park and Byung-Chul Lee and Kyung-Ho Yu and Mi Sun Oh and Dong-Eog Kim and Wi-Sun Ryu and Jay Chol Choi and Jee-Hyun Kwon and Wook-Joo Kim and Dong-Ick Shin and Sung-Il Sohn and Jeong-Ho Hong and Man-Seok Park and Kang-Ho Choi and Ki-Hyun Cho and Juneyoung Lee and Hee-Joon Bae}, title = {Comparative effectiveness of combined antiplatelet treatments in acute minor ischaemic stroke}, volume = {7}, number = {1}, pages = {13--21}, year = {2022}, doi = {10.1136/svn-2020-000841}, publisher = {BMJ Specialist Journals}, abstract = {Background No study has thoroughly compared the effectiveness of combined antiplatelet treatments (other than clopidogrel{\textendash}aspirin) versus clopidogrel{\textendash}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{\textendash}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{\textpm}13 years) who met the eligibility criteria, aspirin, clopidogrel{\textendash}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{\textendash}aspirin group. In the weighted Cox proportional hazards analysis, the 3-month primary outcome event occurred less frequently in the clopidogrel{\textendash}aspirin group than in the other combination group (weighted HR: 0.82 (0.59{\textendash}1.13)), while no association was found between the aspirin group (weighted HR: 1.04 (0.76{\textendash}1.44)) or other combination group and the 3-month primary outcome.Conclusion Other combined antiplatelet treatment, compared with aspirin alone or clopidogrel{\textendash}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{\textendash}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.}, issn = {2059-8688}, URL = {https://svn.bmj.com/content/7/1/13}, eprint = {https://svn.bmj.com/content/7/1/13.full.pdf}, journal = {Stroke and Vascular Neurology} }