PMID- 38286486
OWN - NLM
STAT- Publisher
LR  - 20240129
IS  - 2059-8696 (Electronic)
IS  - 2059-8688 (Linking)
DP  - 2024 Jan 29
TI  - Discontinuation of antiplatelet therapy after stent-assisted coil embolisation of 
      cerebral aneurysm: a nationwide cohort study.
LID - svn-2023-002882 [pii]
LID - 10.1136/svn-2023-002882 [doi]
AB  - INTRODUCTION: Stent-assisted coil embolisation (SACE) for the treatment of 
      unruptured cerebral aneurysms has been increasingly used. Long-term advantages of 
      antiplatelet therapy (APT) post-SACE treatment are still not well understood. We 
      investigated the long-term effects of APT on clinical prognosis after SACE. 
      PATIENTS AND METHODS: We conducted a retrospective study using nationwide health 
      insurance claims data from South Korea, including patients with cerebral aneurysm 
      treated with SACE from January 2009 to December 2020. The study outcomes 
      consisted of the occurrence of cerebral infarction and major haemorrhage. To 
      evaluate the impact of APT, we employed a multivariable time-dependent Cox 
      proportional hazards regression model for each of the three distinct periods: 
      1-12 months, 12-24 months and >24 months after SACE. RESULTS: This study included 
      17 692 unruptured cerebral aneurysm patients treated with SACE. During the mean 
      follow-up of 4.2 years, there were 379 (2.1%) patients with cerebral infarction 
      and 190 (1.1%) patients with major haemorrhage. The percentage of patients 
      receiving APT was 79.5% at 1 year, which gradually decreased to 58.3% at 2 years 
      after SACE. APT was beneficial in preventing cerebral infarction within 12 months 
      after SACE (adjusted HR (aHR) 0.56; 95% CI, 0.35 to 0.89; p=0.014). After 12 
      months, this association was not evident. APT increased the risk of haemorrhage 
      after 24 months (aHR 1.76; 95% CI 1.11 to 2.87; p=0.016). DISCUSSION AND 
      CONCLUSION: Our findings suggest that in patients with unruptured cerebral 
      aneurysm treated with SACE, the reasonable duration of APT for preventing 
      cerebral infarction might be 1 year after SACE.
CI  - (c) Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No 
      commercial re-use. See rights and permissions. Published by BMJ.
FAU - Baik, Minyoul
AU  - Baik M
AD  - Department of Neurology, Yongin Severance Hospital, Yonsei University College of 
      Medicine, Yongin-si, Gyeonggi-do, Korea (the Republic of).
FAU - Jeon, Jimin
AU  - Jeon J
AD  - Department of Neurology, Yongin Severance Hospital, Yonsei University College of 
      Medicine, Yongin-si, Gyeonggi-do, Korea (the Republic of).
FAU - Kim, Jinkwon
AU  - Kim J
AUID- ORCID: 0000-0003-0156-9736
AD  - Department of Neurology, Yongin Severance Hospital, Yonsei University College of 
      Medicine, Yongin-si, Gyeonggi-do, Korea (the Republic of).
FAU - Yoo, Joonsang
AU  - Yoo J
AUID- ORCID: 0000-0003-1169-6798
AD  - Department of Neurology, Yongin Severance Hospital, Yonsei University College of 
      Medicine, Yongin-si, Gyeonggi-do, Korea (the Republic of) quarksea@gmail.com.
LA  - eng
PT  - Journal Article
DEP - 20240129
PL  - England
TA  - Stroke Vasc Neurol
JT  - Stroke and vascular neurology
JID - 101689996
SB  - IM
OTO - NOTNLM
OT  - Aneurysm
OT  - Stents
OT  - Stroke
COIS- Competing interests: MB received research grants from Daewoong Pharmaceuticals. 
      JY received research grants from Chong Kun Dang Pharmaceuticals. JK received 
      research grants from Chong Kun Dang and Myung In Pharmaceuticals. The authors 
      declare no potential conflicts of interest.
EDAT- 2024/01/30 00:42
MHDA- 2024/01/30 00:42
CRDT- 2024/01/29 20:44
PHST- 2023/10/01 00:00 [received]
PHST- 2023/12/07 00:00 [accepted]
PHST- 2024/01/30 00:42 [medline]
PHST- 2024/01/30 00:42 [pubmed]
PHST- 2024/01/29 20:44 [entrez]
AID - svn-2023-002882 [pii]
AID - 10.1136/svn-2023-002882 [doi]
PST - aheadofprint
SO  - Stroke Vasc Neurol. 2024 Jan 29:svn-2023-002882. doi: 10.1136/svn-2023-002882.