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Abstract

Objective:

To investigate whether prestroke antiplatelet agent (PA) use was associated with initial stroke severity.

Methods:

This was a retrospective, case-control study based on data from a prospectively collected hospital-based stroke registry (Korea University Stroke Registry). A total of 3,025 patients who were admitted with a diagnosis of first-ever ischemic stroke within 5 days of symptom onset were included. Stroke severity was measured with the NIH Stroke Scale (NIHSS). NIHSS score ≤4 at admission was categorized as mild stroke. Patients from the PA group were matched with those from the non-PA group using estimated propensity scores at a 1:1 ratio. Stepwise multivariable logistic regression analyses were performed on patients in the matched datasets with initial mild stroke.

Results:

Patients' mean age was 66.3 ± 13.0 years, and 1,850 were men (61.5%). A total of 748 patients had been taking antiplatelet agents prior to stroke onset; 644 patients (86.1%) were taking a single antiplatelet agent. Among these agents, aspirin (83.7%) was the most common. A total of 102 patients (13.6%) were taking 2 antiplatelet agents. Multivariable analysis after propensity score matching demonstrated that PA use was associated with initial mild stroke (odds ratio 1.344; 95% confidence interval 1.014–1.782).

Conclusions:

PA use was associated with decreased first-ever stroke severity, suggesting that it has a beneficial effect.

Classification of evidence:

This study provides Class II evidence that prestroke use of antiplatelet agents reduces stroke severity in patients with first-ever acute ischemic stroke.

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Supplementary Material

File (figure_e-1.pdf)
File (table_e-1.pdf)

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Information & Authors

Information

Published In

Neurology®
Volume 84Number 11March 17, 2015
Pages: 1080-1089
PubMed: 25672919

Publication History

Received: March 18, 2014
Accepted: November 13, 2014
Published online: February 11, 2015
Published in print: March 17, 2015

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Disclosure

The authors report no disclosures relevant to the manuscript. Go to Neurology.org for full disclosures.

Study Funding

Supported by funding from Samjin Pharmaceutical Company Ltd.

Authors

Affiliations & Disclosures

Jin-Man Jung, MD, PhD
From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
funding of Samjin and Dongwha pharmacertical companies
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Jungsoon Choi, PhD
From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Mi-Yeon Eun, MD
From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Woo-Keun Seo, MD, PhD
From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
Korean Stroke Society (Korean Stroke Society Young Investigator's Award, KSS-2009-003)
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Kyung-Hee Cho, MD, PhD
From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Sungwook Yu, MD, PhD
From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
Journal of Neurosonology (The Korean Society of Neurosonology), editor, 2012-2014
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Kyungmi Oh, MD, PhD
From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Soonwoong Hong, MD
From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
NONE
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
NONE
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE
Kwang-Yeol Park, MD, PhD
From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
Disclosure
Scientific Advisory Boards:
1.
NONE
Gifts:
1.
NONE
Funding for Travel or Speaker Honoraria:
1.
NONE
Editorial Boards:
1.
I have served as an Editor-in-Chief of
Patents:
1.
NONE
Publishing Royalties:
1.
NONE
Employment, Commercial Entity:
1.
NONE
Consultancies:
1.
NONE
Speakers' Bureaus:
1.
NONE
Other Activities:
1.
NONE
Clinical Procedures or Imaging Studies:
1.
NONE
Research Support, Commercial Entities:
1.
NONE
Research Support, Government Entities:
1.
I was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2010- 0023596).
Research Support, Academic Entities:
1.
NONE
Research Support, Foundations and Societies:
1.
NONE
Stock/stock Options/board of Directors Compensation:
1.
NONE
License Fee Payments, Technology or Inventions:
1.
NONE
Royalty Payments, Technology or Inventions:
1.
NONE
Stock/stock Options, Research Sponsor:
1.
NONE
Stock/stock Options, Medical Equipment & Materials:
1.
NONE
Legal Proceedings:
1.
NONE

Notes

Correspondence to Dr. Jung: [email protected]
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

Author Contributions

J.-M. Jung designed the study, collected the data, performed statistical analyses, and wrote the manuscript. K.-Y. Park contributed to the manuscript as co-first author. J. Choi recommended the study design and performed statistical analyses. M.-Y. Eun, W.-K. Seo, K.-H. Cho, S. Yu, K. Oh, and S. Hong collected and qualified the data. W.-K. Seo supervised the project and critically revised the manuscript.

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  8. Prior Antithrombotic Use Is Associated With Favorable Mortality and Functional Outcomes in Acute Ischemic Stroke, Stroke, 47, 8, (2066-2074), (2016).https://doi.org/10.1161/STROKEAHA.115.012414
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