title: Prestroke antiplatelet agents in first-ever ischemic stroke: clinical effects.
abstract: OBJECTIVE
  To investigate whether prestroke antiplatelet agent (PA) use was associated with initial stroke severity.
  
  
  METHODS
  This was a retrospective, case-control study based on data from a prospectively collected hospital-based stroke registry (Korea University Stroke Registry). A total of 3,025 patients who were admitted with a diagnosis of first-ever ischemic stroke within 5 days of symptom onset were included. Stroke severity was measured with the NIH Stroke Scale (NIHSS). NIHSS score ≤4 at admission was categorized as mild stroke. Patients from the PA group were matched with those from the non-PA group using estimated propensity scores at a 1:1 ratio. Stepwise multivariable logistic regression analyses were performed on patients in the matched datasets with initial mild stroke.
  
  
  RESULTS
  Patients' mean age was 66.3 ± 13.0 years, and 1,850 were men (61.5%). A total of 748 patients had been taking antiplatelet agents prior to stroke onset; 644 patients (86.1%) were taking a single antiplatelet agent. Among these agents, aspirin (83.7%) was the most common. A total of 102 patients (13.6%) were taking 2 antiplatelet agents. Multivariable analysis after propensity score matching demonstrated that PA use was associated with initial mild stroke (odds ratio 1.344; 95% confidence interval 1.014-1.782).
  
  
  CONCLUSIONS
  PA use was associated with decreased first-ever stroke severity, suggesting that it has a beneficial effect.
  
  
  METHODS
  This study provides Class II evidence that prestroke use of antiplatelet agents reduces stroke severity in patients with first-ever acute ischemic stroke.
authors: From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea. sodium75@medimail.co.kr.
authors: Jin-Man
authors: JM
authors: Jung
authors: From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
authors: Jungsoon
authors: J
authors: Choi
authors: From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
authors: Mi-Yeon
authors: MY
authors: Eun
authors: From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
authors: Woo-Keun
authors: WK
authors: Seo
authors: From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
authors: Kyung-Hee
authors: KH
authors: Cho
authors: From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
authors: Sungwook
authors: S
authors: Yu
authors: From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
authors: Kyungmi
authors: K
authors: Oh
authors: From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
authors: Soonwoong
authors: S
authors: Hong
authors: From the Department of Neurology (J.-M.J.), Korea University Ansan Hospital, Korea University College of Medicine, Ansan; the Department of Mathematics (J.C.), School of Natural Sciences, Hanyang University, Seoul; the Department of Neurology (M.-Y.E.), KEPCO Medical Center, Seoul; the Department of Neurology (W.-K.S., K.O.), Korea University Kuro Hospital, Korea University College of Medicine, Seoul; the Department of Neurology (K.-H.C., S.Y., S.H.), Korea University Anam Hospital, Korea University College of Medicine, Seoul; and the Department of Neurology, Chung-Ang University Hospital (K.-Y.P.), Chung-Ang University College of Medicine, Seoul, Korea.
authors: Kwang-Yeol
authors: KY
authors: Park
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects*; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors