ABSTRACT
BACKGROUND: Following transient ischemic attack (TIA) and minor stroke, the risk of recurrent stroke can be significantly reduced with short-duration dual antiplatelet therapy (DAPT). We wish to investigate whether 10 days of DAPT is as effective as 21 days' treatment. STUDY DESIGN: This is an open-label, randomized, parallel-group study comparing whether 10 days of DAPT treatment (ASA + clopidogrel) is non-inferior to 21 days of DAPT in patients with acute ischemic stroke (AIS) or high-risk TIA. In both groups, DAPT is started within 24 hours of symptom onset. This study is being conducted in approximately 15 study sites in the Kingdom of Saudi Arabia. The planned sample size is 1932. OUTCOMES: Non-inferiority of 10 days compared to 21 days of DAPT in the prevention of the composite endpoint of stroke and death at 90 days in AIS/TIA patients. The primary safety outcome is major intra-cranial and systemic hemorrhage. STUDY PERIOD: Enrolment started in the second quarter of 2023, and the completion of the study is expected in the fourth quarter of 2025. DISCUSSION: The trial is expected to show that 10 days of DAPT is non-inferior for the prevention of early recurrence of vascular events in patients with high-risk TIAs and minor strokes.
ABSTRACT
PURPOSE: This study aimed to investigate the outcomes of endovascular thrombectomy-treated patients in King Fahad Medical City, Riyadh, Saudi Arabia. METHODS: A retrospective cohort study of acute ischemic stroke patients treated with endovascular thrombectomy. Patients were included in the study between January 2015 and December 2022. Good outcomes were defined as a modified Rankin Scale (mRS) of 0-2 at 90 days. Multivariate logistic regression analysis was performed to identify the independent factors associated with good outcomes. RESULTS: During the study period, 369 patients with acute ischemic stroke (mean ± SD age, 61/- 15.1 yrs; 55.4 % male) underwent mechanical thrombectomy. Median National Institute of Health Stroke Scale (NIHSS) 15. Intravenous thrombolysis was administered to 34.5 % of the patients. Successful recanalization in the anterior circulation was achieved in 84.8 % of patients. Data from mRS performed after 90 days in the anterior circulation were available for 71.2 % of the patients. Of these, 41 % showed a good outcome, and the mortality rate was 22.4 %. The significant factors associated with good outcomes were age, NIHSS score, Alberta Stroke Program Early Computed Tomography Score (ASPECTS), and short arterial puncture to recanalization. CONCLUSION: The number of patients who underwent endovascular thrombectomy has increased over time. The treatment outcomes and mortality were comparable with those of previous endovascular thrombectomy registries despite the high prevalence of DM, lower ASPECT score, and prolonged onset-to-recanalization time.
Subject(s)
Brain Ischemia , Endovascular Procedures , Ischemic Stroke , Stroke , Humans , Male , Female , Ischemic Stroke/diagnostic imaging , Ischemic Stroke/therapy , Retrospective Studies , Saudi Arabia , Stroke/diagnostic imaging , Stroke/therapy , Thrombectomy/adverse effects , Thrombectomy/methods , Treatment Outcome , Endovascular Procedures/adverse effects , Brain Ischemia/diagnostic imaging , Brain Ischemia/therapyABSTRACT
Background: Early-stage prostate cancer can be asymptomatic. The digital rectal exam (DRE) and the prostate specific antigen (PSA) test are usually used for prostate cancer screening. This study aims to assess knowledge and attitudes towards prostate cancer screening among males in Saudi Arabia. Materials and Methods: A cross-sectional study was conducted on Saudi males above the age of 40. A self-reported questionnaire was distributed online. Results: A total of 368 males completed the questionnaire. In the studied group, 64.5% had heard about prostate cancer through social media (46.7%), the internet (40.1%), or healthcare providers (18.6%). In addition, around 20.3% of the participants had heard about the PSA screening test. Moreover, 55.2% of participants had an inadequate level of knowledge about prostate cancer and the PSA test, while 53.1% had a negative attitude. Conclusion: There was a poor level of knowledge and attitude towards screening for prostate cancer among males in Saudi Arabia. This could be due to the lack of education on the risks of prostate cancer by healthcare providers.
