PMID- 37433663 OWN - NLM STAT- Publisher LR - 20230907 IS - 1759-8486 (Electronic) IS - 1759-8478 (Linking) DP - 2023 Jul 11 TI - Relation between duration of dual antiplatelet therapy and risk of ischemic stroke after stent-assisted treatment of cerebral aneurysm (DAPTS ACE-registry). LID - jnis-2023-020495 [pii] LID - 10.1136/jnis-2023-020495 [doi] AB - BACKGROUND: The optimal duration of dual antiplatelet therapy (DAPT) in patients with cerebral aneurysm who undergo stent-assisted coil embolization (SACE) has not been established. We aimed to clarify the association between duration of DAPT and incidence of ischemic stroke in patients with cerebral aneurysm. METHODS: We registered patients with cerebral aneurysm who underwent SACE in 27 hospitals in Japan. Those treated with DAPT (aspirin and clopidogrel) were eligible for inclusion in a previously reported randomized control trial (RCT). Patients who were ineligible or refused to participate to the RCT were followed-up for 15 months after SACE as the non-RCT cohort. Our study examined both the RCT and non-RCT cohorts. The primary and secondary outcomes were ischemic stroke and hemorrhagic events. RESULTS: Among the 313 patients registered, 296 were included for analysis (of these, 136 were RCT patients and 160 were non-RCT patients). Patients who were treated with DAPT for more than 6 months (n=191) were classified as the long-term DAPT group. Those treated less than 6 months (n=105) were classified as the short-term group. The incidence of ischemic stroke did not significantly differ between the long-term group (2.5 per 100 person-years) and the short-term group (3.2 per 100 person-years); nor did incidence of hemorrhagic events (0.8 and 3.2 per 100 person-years, respectively). The period of DAPT was not significantly associated with incidence rates of ischemic stroke or hemorrhagic events. CONCLUSIONS: Duration of DAPT was not associated with the incidence of ischemic stroke in the first 15 months after SACE. CI - (c) Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. FAU - Ozaki, Tomohiko AU - Ozaki T AUID- ORCID: 0000-0003-1558-4785 AD - Neurosurgery, National Hospital Organization Osaka National Hospital, Osaka, Japan. FAU - Yamagami, Hiroshi AU - Yamagami H AD - Stroke Neurology, National Hospital Organization Osaka National Hospital, Osaka, Japan yamagami.brain@outlook.com. FAU - Morimoto, Masafumi AU - Morimoto M AD - Neurosurgery, Yokohama Shintoshi Neurosurgical Hospital, Yokohama, Kanagawa, Japan. FAU - Imamura, Hirotoshi AU - Imamura H AUID- ORCID: 0000-0001-8923-7861 AD - Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan. FAU - Hatano, Taketo AU - Hatano T AD - Neurosurgery, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan. FAU - Oishi, Hidenori AU - Oishi H AD - Department of Neurosurgery, Juntendo University, Faculty of Medicine, Tokyo, Japan. FAU - Haraguchi, Koichi AU - Haraguchi K AD - Neurosurgery, Hakodate Shintoshi Hospital, Hakodate, Japan. FAU - Yoshimura, Shinichi AU - Yoshimura S AD - Neurosurgery, Hyogo College of Medicine, Nishinomiya city, Japan. FAU - Satow, Tetsu AU - Satow T AD - Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. FAU - Sugiu, Kenji AU - Sugiu K AD - Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Kita-ku, Okayama, Japan. FAU - Iihara, Koji AU - Iihara K AD - Neurosurgery, National Cerebral and Cardiovascular Center Hospital, Suita, Osaka, Japan. FAU - Matsumaru, Yuji AU - Matsumaru Y AD - Department of Neurology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan. FAU - Hayakawa, Mikito AU - Hayakawa M AD - Department of Neurology, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan. FAU - Matsumoto, Yasushi AU - Matsumoto Y AD - Division of Development and Discovery of Interventional Therapy, Tohoku University Hospital, Sendai, Miyagi, Japan. FAU - Sakai, Chiaki AU - Sakai C AD - Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan. FAU - Miyamoto, Susumu AU - Miyamoto S AD - Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. FAU - Kitagawa, Kazuo AU - Kitagawa K AD - Neurology, Tokyo Women's Medical University School of Medicine, Shinjuku-ku, Tokyo, Japan. FAU - Kagimura, Tatsuo AU - Kagimura T AD - Foundation for Biomedical Research and Innovation at Kobe, Translational Research Center for Medical Innovation, Kobe, Hyogo, Japan. FAU - Sakai, Nobuyuki AU - Sakai N AD - Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan. LA - eng PT - Journal Article DEP - 20230711 PL - England TA - J Neurointerv Surg JT - Journal of neurointerventional surgery JID - 101517079 SB - IM OTO - NOTNLM OT - Aneurysm OT - Intervention COIS- Competing interests: HY reports research grants from Bristol-Myers Squibb and lecturer's fees from Stryker, Medtronic, Terumo, Johnson & Johnson, Bristol-Myers Squibb, Daiichi Sankyo, Otsuka Pharmaceutical. and Medico's Hirata. HI reports lecture's fee from Medtronic Japan, Daiichi Sankyo, Johnson & Johnson, Stryker Jaoan, Terumo, and Asahi Intecc. HO reports research grants from Terumo, Stryker, Medtronic, Medikit, and Kaneka and consulting fees from Medtronic, Stryker, Kaneka, and Asahi Intec. KS reports lecturer's fees from Medtronic Japan, Kaneka Medix, and Terumo. YM reports lecturer's fees from Daiichi Sakyo, Otsuka Pharmaceutical, Medtronic, Stryker, Terumo, Johnson &Johnson, Kaneka, and Medico's Hirata. KK reports lecturer's fees from Kyowa Kirin and Daiichi Sankyo. YM serves in an advisory role for GE Healthcare, Fuji Systems, Medico's Hirata, and Stryker; he reports patents and royalties from Sumitomo Bakelite and lecturer's fees from GE Healthcare, Stryker, Medtronic, Medico's Hirata, Century Medical, Takeda Pharmaceutical Company, Otsuka Pharmaceutical, Kaneka, and Fuji Systems. TS reports research grants from CANON medical systems, lecturer's fees from Medtronic, and consulting fees from Kaneka Medix. CS reports research grants from Biomedical Solutions, Medtronic, and Terumo and lecturer's fees from Asahi-Intec, Biomedical Solutions, Medtronic, and Terumo; he is also a member of the advisory boards of Johnson & Johnson, Medtronic, and Terumo. EDAT- 2023/07/12 01:07 MHDA- 2023/07/12 01:07 CRDT- 2023/07/11 21:22 PHST- 2023/04/28 00:00 [received] PHST- 2023/06/18 00:00 [accepted] PHST- 2023/07/12 01:07 [pubmed] PHST- 2023/07/12 01:07 [medline] PHST- 2023/07/11 21:22 [entrez] AID - jnis-2023-020495 [pii] AID - 10.1136/jnis-2023-020495 [doi] PST - aheadofprint SO - J Neurointerv Surg. 2023 Jul 11:jnis-2023-020495. doi: 10.1136/jnis-2023-020495.