The application of dual antiplatelet treatment combined with ABCD3-Ⅰ score in treatment of transient ischemic attack / 中国医师进修杂志

ABSTRACT

Objective To explore the application value of aspirin and clopidogrel dual antiplatelet treatment combined with ABCD3-Ⅰ scores in treatment of transient ischemic attack (TIA).Methods Risk factors were evaluated and imaging was performed in 48 h in one hundred and twenty patients with first attack of TIA [magnetic resonance imaging (MRI),magnetic resonance angiography (MRA),diffusion weighted imaging (DWI) scan].According to the ABCD3-Ⅰ evaluation method,the patients were divided into low risk group,moderate risk group and high risk group.Single resistance group was given aspirin 100 mg/d; double resistance group was given aspirin 100 mg/d combined with clopidogrel 75 mg/d.Then the incidence of ischemic stroke in each group within 7 days was observed,and the effects of dual anti-platelet and aspirin monotherapy were compared.Results Within 7 d after TIA,low-risk single resistance group and low-risk double resistance group had no stroke; 9 cases (42.9％,9/21) had stroke in moderate-risk single resistance group,2 cases (2/19) had stroke in moderate-risk double resistance group,and there was significant difference (P ＜ 0.05) ; 9 cases (9/18) had stroke in high-risk single resistance group,3 cases (15.0％,3/20) had stroke in high-risk double resistance group,and there was significant difference (P ＜ 0.05).Three patients in single resistance group and 4 cases in double resistance group showed gastrointestinal adverse reactions such as nausea,acid reflux,and there was no significant difference between 2 groups (P ＞ 0.05).Each group during treatment showed no bleeding tendency,and liver and kidney function in patients was normal.Conclusion In patients of the moderate risk and high risk of ABCD3-Ⅰ scores,dual anti-platelet may have an advantage over single druge in the prevention of ischemic stroke.