Dual Antiplatelet Therapy in the Management of Acute Minor Ischemic Stroke and High-Risk Transient Ischemic Attack: An Expert Consensus Statement From Taiwan Stroke Society and Taiwan Society of Emergency Medicine

被引：3

作者：

Chen, Po -Lin ^{[1
]}

Chen, Ying-Ju ^{[2
]}

Chung, Chih-Ping ^{[3
]}

Seak, Chen-June ^{[4
,5
]}

Jeng, Jiann-Shing ^{[6
,7
]}

Hsieh, Ming-Ju ^{[8
]}

Lien, Li -Ming ^{[9
]}

Chen, Jiann-Hwa ^{[10
]}

Chen, Yu-Wei ^{[11
]}

Chiu, Te-Fa ^{[12
]}

Lee, Jiunn-Tay ^{[13
,16
]}

Ng, Chip-Jin ^{[5
,14
,15
]}

机构：

[1] Taichung Vet Gen Hosp, Neurol Inst, Div Neurol, Taichung, Taiwan

[2] Taipei Vet Gen Hosp, Dept Emergency Med, Taipei, Taiwan

[3] Taipei Vet Gen Hosp, Neurol Inst, Dept Neurol, Taipei, Taiwan

[4] New Taipei Municipal Tucheng Hosp, Dept Emergency Med, New Taipei, Taiwan

[5] Chang Gung Univ, Coll Med, Taoyuan, Taiwan

[6] Natl Taiwan Univ Hosp, Dept Neurol, Taipei, Taiwan

[7] Natl Taiwan Univ Hosp, Stroke Ctr, Taipei, Taiwan

[8] Natl Taiwan Univ Hosp, Dept Emergency Med, Taipei, Taiwan

[9] Shin Kong Wu Ho Su Mem Hosp, Dept Neurol, Taipei, Taiwan

[10] Cathay Gen Hosp, Dept Emergency Med, Taipei, Taiwan

[11] Landseed Int Hosp, Dept Neurol, Taoyuan, Taiwan

[12] China Med Univ Hosp, Dept Emergency Med, Taichung, Taiwan

[13] Triserv Gen Hosp, Natl Def Med Ctr, Dept Neurol, Taipei, Taiwan

[14] Chang Gung Mem Hosp, Dept Emergency Med, Taoyuan, Taiwan

[15] Chang Gung Mem Hosp, Dept Emergency Med, 5 Fuxing St, Taoyuan 333423, Taiwan

[16] Natl Def Med Ctr, Triserv Gen Hosp, Dept Neurol, 325,Sec 2,Chenggong Rd, Taipei 114202, Taiwan

来源：

JOURNAL OF ACUTE MEDICINE | 2022年 / 12卷 / 03期

关键词：

acute minor ischemic stroke; consensus statement; dual antiplatelet therapy; transient ischemic attack; OPEN-LABEL; CLOPIDOGREL; ASPIRIN; DIPYRIDAMOLE; TICAGRELOR; PHASE;

D O I：

10.6705/j.jacme.202209_12(3).0001

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

The aim of this review is to achieve a consensus between Taiwan Stroke Society (TSS) and Taiwan Society of Emergency Medicine (TSEM) to manage acute non-cardioembolic minor ischemic stroke (MIS) and high-risk transient ischemic attack (TIA). The methodology is to review the recent findings from clinical trials of dual antiplatelet therapy (DAPT) from 2010 to 2021 and updates in clinical practice guidelines from 2018 to 2022 for non-cardioembolic MIS/TIA management at the acute stage. Four leading clinical studies, CHANCE, POINT, THALES, and CHANCE-2 along with other relevant studies introducing DAPT, are discussed in this review. The risk-benefi t profi le between stroke recurrence reduction and major bleeding increase is also elucidated. TSS and TSEM concluded that for patients presenting with non-cardioembolic MIS or high-risk TIA who did not receive intravenous alteplase, initiation of DAPT within 24 hours after stroke onset and continued up to 21 days, followed by antiplatelet monotherapy, is effective in reducing recurrent ischemic stroke for a period of up to 90 days.

引用

页码：85 / 95

页数：11

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