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Aspirin better than clopidogrel on major adverse cardiovascular events reduction after ischemic stroke: A retrospective nationwide cohort study

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Listed:
  • Amelia Nur Vidyanti
  • Lung Chan
  • Cheng-Li Lin
  • Chih-Hsin Muo
  • Chung Y Hsu
  • You-Chia Chen
  • Dean Wu
  • Chaur-Jong Hu

Abstract

Background: Several clinical trials reported that clopidogrel was superior to aspirin in secondary stroke prevention by reducing the risk of major adverse cardiovascular events (MACE). We aimed to compare the efficacy of clopidogrel with aspirin in reducing one-year risk of MACE based on real-world evidence from Taiwan Health Insurance Database. Methods: We identified ischemic stroke patients between 2000 and 2012 who took aspirin or clopidogrel within 7 days of stroke onset for 1-year follow-up. The primary outcome was one-year MACE including recurrent stroke, acute myocardial infarction, and death. Propensity score matching and conditional Cox proportional hazards regression were conducted to control the confounding factors. Results: From 9,089 ischemic stroke patients, we found 654 patients on aspirin and 465 patients on clopidogrel who met the selective inclusion criteria. After propensity score matching, 379 patients were selected from each group. The clopidogrel group had a 1.78-fold MACE risk compared with the aspirin group at one-year follow-up (95% CI = 1.41–2.26, p

Suggested Citation

  • Amelia Nur Vidyanti & Lung Chan & Cheng-Li Lin & Chih-Hsin Muo & Chung Y Hsu & You-Chia Chen & Dean Wu & Chaur-Jong Hu, 2019. "Aspirin better than clopidogrel on major adverse cardiovascular events reduction after ischemic stroke: A retrospective nationwide cohort study," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-10, August.
    • Handle: RePEc:plo:pone00:0221750
    DOI: 10.1371/journal.pone.0221750
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    References listed on IDEAS

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    1. J. Logman & Bart Heeg & Johan Herlitz & Ben Hout, 2010. "Costs and consequences of clopidogrel versus aspirin for secondary prevention of ischaemic events in (high-risk) atherosclerotic patients in Sweden," Applied Health Economics and Health Policy, Springer, vol. 8(4), pages 251-265, July.
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