JAMA Sub-Journal: The systolic blood pressure at the onset of new TIA and minor stroke determines the 90-day DAPT treatment benefit

The risk of ischemic stroke within 3 months after a small stroke or high-risk transient ischemic attack (TIA) can exceed 10%

The risk of ischemic stroke within 3 months after a small stroke or high-risk transient ischemic attack (TIA) can exceed 10%

In patients with baseline systolic blood pressure (SBP) ≥140mmHg, DAPT is associated with a lower risk of stroke recurrence, and in patients with baseline systolic blood pressure (SBP) ≥140mmHg, DAPT is associated with a lower risk of stroke recurrence.

In trials of patients who received treatment within 6 hours of the onset of ischemic stroke, the benefit of antihypertensive therapy remains uncertain

In order to further evaluate the interaction between baseline blood pressure and the treatment group (DAPT vs.

Prevent JAMA

The trial is a multicenter trial conducted at 269 locations in 10 countries in North America, Europe, Australia and New Zealand from 2010 to 2018

Exposure factors are the baseline SBP<140mmHg and ≥140mmHg, and SBP (<140mmHg and ≥140mmHg) × treatment group (aspirin and DAPT) interaction items

Among 4781 patients, the mean (SD) age was 64.

There were 946 patients (19.

The KM curve of ischemic stroke events within 90 days was stratified according to the results of the first measurement at baseline

The KM curve of ischemic stroke events within 90 days was stratified according to the results of the first measurement at baseline

In the subgroup with SBP<140 mmHg, compared with aspirin alone for ischemic stroke, the risk of DAPT treatment was reduced by 64% (HR=0.

DAPT patients with SBP<140 mmHg had a 19% increased risk (HR=0.

Kaplan-Meier curve of ischemic stroke events within 90 days of treatment with aspirin and DAPT

Kaplan-Meier curve of ischemic stroke events within 90 days of treatment with aspirin and DAPT

 

In summary, in the POINT trial, patients with SBP less than 140mmHg at the time of onset received greater benefit from 90-day DAPT than patients with higher baseline SBP, especially in reducing the recurrence of early ischemic stroke

In summary, in the POINT trial, patients with SBP less than 140mmHg at the time of onset received greater benefit from 90-day DAPT than patients with higher baseline SBP, especially in reducing the recurrence of early ischemic stroke

references:

Evaluation of Systolic Blood Pressure, Use of Aspirin and Clopidogrel, and Stroke Recurrence in the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke Trial.

Evaluation of Systolic Blood Pressure, Use of Aspirin and Clopidogrel, and Stroke Recurrence in the Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke Trial.


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