UMM Logo

Universitas Muhammadiyah Malang


Free Download Journals Directory


International Journal of Medical Sciences

.: Home > International Journal of Medical Sciences > 2010 > Volume 7 Number 1 > Hirohisa Okuma 1 .., Yasuhisa Kitagawa 2, Takashi Yasuda 2, Kentaro Tokuoka 2, Shigeharu Takagi 3

Comparison between single antiplatelet therapy and combination of antiplatelet and anticoagulation therapy for secondary prevention in ischemic stroke patients with antiphospholipid syndrome

Hirohisa Okuma 1 .., Yasuhisa Kitagawa 2, Takashi Yasuda 2, Kentaro Tokuoka 2, Shigeharu Takagi 3
1. Department of Neurology, Tokai University Tokyo Hospital; 2. Department of Neurology, Tokai University Hachioji Hospital; 3. Department of Neurology, Tokai University School of Medicine.
Abstract :

Satisfactory results have not yet been obtained in therapy for secondary prevention in ischemic stroke patients with antiphospholipid syndrome (APS). We therefore compared single antiplatelet therapy and a combination of antiplatelet and anticoagulation therapy for secondary prevention in ischemic stroke patients with APS. The subjects were 20 ischemic stroke patients with antiphospholipid antibody, 13 with primary antiphospholipid syndrome and 7 with SLE-related antiphospholipid syndrome. Diagnosis
of APS was based on the 2006 Sydney criteria. Eligible patients were randomly assigned to either single antiplatelet therapy (aspirin 100 mg) or a combination of antiplatelet and anticoagulation therapy (target INR: 2.0-3.0; mean 2.4±0.3) for the secondary prevention of stroke according to a double-blind protocol. There was no significant difference between the two groups in age, gender, NIH Stroke Scale on admission, mRS at discharge, or rate of hypertension, diabetes mellitus, hyperlipidemia, or cardiac disease. We obtained Kaplan- Meier survival curves for each treatment. The primary outcome was the occurrence of stroke. The mean follow-up time was 3.9±2.0 years. The cumulative incidence of stroke in
patients with single antiplatelet treatment was statistically significantly higher than that in patients receiving the combination of antiplatelet and anticoagulation therapy (log-rank test, p-value=0.026). The incidence of hemorrhagic complications was similar in the two groups. The recent APASS study did not show any difference in effectiveness for secondary prevention between single antiplatelet (aspirin) and single anticoagulant (warfarin) therapy. Our results indicate that combination therapy may be more effective in APS-related ischemic stroke.

Keywords :
antiphospholipid syndrome, APS-related ischemic stroke, single antiplatelet therapy, combination therapy, Kaplan-Meier survival curves.

Date Deposited : 27 Jul 2011 09:10

Last Modified : 27 Jul 2011 09:10

Official URL: http://www.medsci.org/archive

Volume 7, Number 1, - 2010 , ISSN 1449-1907

Download:
Full Text Original
Abstract : pdf doc
Home | Peta Situs | Admissions | Student Research | E-Journal
Universitas Muhammadiyah Malang © 2011
Developed by Infokom UMM
Last Update : 13 December 2016 20:46Kumpulan file jurnal