Evaluating the Efficacy of Dual Antiplatelet Therapy in Reducing Recurrent Stroke in High-Risk Patients

Ayat  Ullah; Muhammad Omair; Nida Fatima  Daterdiwala; Sana  Saleem; Aqsa   Hayat; Tariq  Khan

doi:10.62497/IRABCS.2024.70

Authors

Ayat Ullah PGR Internal Medicine, MTI LRH, Peshawar Author
Muhammad Omair Mufti Mehmood Memorial Teaching Hospital, Dera Ismael Khan Author https://orcid.org/0009-0007-4166-3571
Nida Fatima Daterdiwala Ziauddin University, Karachi Author https://orcid.org/0000-0002-2724-4975
Sana Saleem Khyber Teaching Hospital, Peshawar Author https://orcid.org/0009-0000-1431-026X
Aqsa Hayat Jinnah Medical College, Peshawar Author https://orcid.org/0009-0003-9131-9569
Tariq Khan Khyber Medical College, Peshawar Author https://orcid.org/0009-0004-4869-7529

DOI:

https://doi.org/10.62497/IRABCS.2024.70

Keywords:

Recurrent stroke, dual antiplatelet therapy, high-risk individuals, single antiplatelet therapy, stroke prevention, randomized controlled trial.

Abstract

Introduction: Still among the primary causes of illness and death worldwide is stroke. Comparatively to single antiplatelet therapy (SAPT), dual antiplatelet therapy (DAPT) has been suggested as a successful approach to lower the risk of recurrent strokes in high-risk patients. This study sought to assess whether DAPT would be effective in avoiding recurrent strokes among high-risk patients at Lady Reading Hospital (LRH) in Peshawar.

Methodology: Using 92 high-risk stroke patients, 92 were assigned to DAPT (n=46) or SAPT (n=46). Over a follow-up period concluding in August 2024, data on demographic, clinical, stroke recurrence rates, and safety outcomes was gathered. Outcomes were assessed using statistical analyses comprising Kaplan-Meier survival analysis and Cox proportional hazards modeling.

Results: With a stroke recurrence rate of 13% instead of 30% in the SAPT group (p=0.026), the DAPT group displayed with p=0.017 the Kaplan-Meier analysis revealed a stroke-free survival rate of 87% in the DAPT group against 70% in the SAPT group. The Cox model showed that DAPT reduced the incidence of recurrent stroke by 60% (HR=0.40). The incidence of major bleeding events was low, with 4.3% in the DAPT group and 2.1% in the SAPT group (p=0.53), indicating an acceptable safety profile.

Conclusion: This study supports the use of DAPT as a more successful tactic than SAPT for low-risk individuals' recurrent stroke prevention. The results highlight the significance of using DAPT in clinical practice and provide important data for the management of stroke in different populations.

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Author Biographies

Ayat Ullah, PGR Internal Medicine, MTI LRH, Peshawar

Former Medical Officer in MTI Bannu. GMC, CPSP and IMC Registered
Nida Fatima Daterdiwala , Ziauddin University, Karachi

House Officer
Sana Saleem, Khyber Teaching Hospital, Peshawar

House Officer
Aqsa Hayat , Jinnah Medical College, Peshawar

Final year, MBBS
Tariq Khan, Khyber Medical College, Peshawar

Final year, MBBS

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