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Comparison of antiplatelet regimens in secondary stroke prevention: a nationwide cohort study

Overview of attention for article published in BMC Neurology, November 2015
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Title
Comparison of antiplatelet regimens in secondary stroke prevention: a nationwide cohort study
Published in
BMC Neurology, November 2015
DOI 10.1186/s12883-015-0480-4
Pubmed ID
Authors

Christine Benn Christiansen, Jannik Pallisgaard, Thomas Alexander Gerds, Jonas Bjerring Olesen, Mads Emil Jørgensen, Anna Karin Numé, Nicholas Carlson, Søren Lund Kristensen, Gunnar Gislason, Christian Torp-Pedersen

Abstract

In patients with ischemic stroke of non-cardioembolic origin, acetylsalicylic acid, clopidogrel, or a combination of acetylsalicylic acid and dipyridamole are recommended for the prevention of a recurrent stroke. The purpose of this study was to examine the risk of bleeding or recurrent stroke associated with these three treatments. Patients who were discharged with first-time ischemic stroke from 2007-2010, with no history of atrial fibrillation were identified from Danish nationwide registries. Hazard ratios (HRs) and 1-year risks of recurrent ischemic stroke and bleeding were calculated for each antiplatelet regimen. Among patients discharged after first-time ischemic stroke, 3043 patients were treated with acetylsalicylic acid, 12,295 with a combination of acetylsalicylic acid and dipyridamole, and 3885 with clopidogrel. Adjusted HRs for clopidogrel versus the combination of acetylsalicylic acid and dipyridamole were 1.02 (95 % confidence interval [CI]: 0.89-1.17) for ischemic stroke and 1.06 (95 % CI: 0.83-1.35) for bleeding. Adjusted HRs for acetylsalicylic acid versus the combination of acetylsalicylic acid and dipyridamole were 1.48 (95 % CI: 1.31-1.67) for stroke and 1.47 (95 % CI: 1.18-1.82) for bleeding. Clopidogrel versus acetylsalicylic acid yielded HRs of 0.69 (95 % CI: 0.59-0.81) and 0.72 (95 % CI: 0.55-0.96) for stroke and bleeding, respectively. The 1-year predicted risks associated with acetylsalicylic acid, the combination of acetylsalicylic acid and dipyridamole, and clopidogrel were 11.1 (95 % CI: 10.2-12.2), 7.7 (95 % CI: 7.3-8.3), and 8.0 (95 % CI: 6.9-8.7) for ischemic stroke, respectively; while, the risks for bleeding were 3.4 (95 % CI: 2.8-3.9), 2.4 (95 % CI: 2.1-2.7), and 2.4 (95 % CI: 1.9-2.9), respectively. Clopidogrel and the combination of acetylsalicylic acid and dipyridamole were associated with similar risks for recurrent ischemic stroke and bleeding; whereas acetylsalicylic acid was associated with higher risks for both ischemic stroke and bleeding. The latter finding may partially be explained by selection bias.

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The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 68 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 68 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 18%
Researcher 12 18%
Student > Bachelor 10 15%
Student > Ph. D. Student 6 9%
Student > Doctoral Student 4 6%
Other 10 15%
Unknown 14 21%
Readers by discipline Count As %
Medicine and Dentistry 27 40%
Neuroscience 6 9%
Nursing and Health Professions 5 7%
Pharmacology, Toxicology and Pharmaceutical Science 5 7%
Agricultural and Biological Sciences 2 3%
Other 6 9%
Unknown 17 25%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 November 2015.
All research outputs
#18,616,159
of 23,881,329 outputs
Outputs from BMC Neurology
#1,870
of 2,532 outputs
Outputs of similar age
#195,629
of 287,836 outputs
Outputs of similar age from BMC Neurology
#56
of 70 outputs
Altmetric has tracked 23,881,329 research outputs across all sources so far. This one is in the 19th percentile – i.e., 19% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,532 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.0. This one is in the 22nd percentile – i.e., 22% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 287,836 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 27th percentile – i.e., 27% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 70 others from the same source and published within six weeks on either side of this one. This one is in the 15th percentile – i.e., 15% of its contemporaries scored the same or lower than it.