title: Ozagrel for Patients With Noncardioembolic Ischemic Stroke: A Propensity Score-Matched Analysis.
abstract: OBJECTIVE
  Ozagrel sodium (ozagrel), a thromboxane A2 synthesis inhibitor, is used for ischemic stroke patients in several countries, despite a lack of strict evidence of its benefits. We investigated whether ozagrel was beneficial for patients with atherothrombotic stroke or lacunar infarction.
  
  
  METHODS
  This was a retrospective observational study using the Diagnosis Procedure Combination database in Japan. We identified patients with atherothrombotic stroke or lacunar infarction who were admitted to 781 hospitals from July 1, 2010 to March 31, 2012. Propensity score-matched analyses were performed separately for patients with atherothrombotic stroke and those with lacunar infarction, which balanced differences in baseline characteristics between patients who received ozagrel (ozagrel group) and those who did not (control group) in each stroke subtype. The modified Rankin Scale scores at discharge and occurrence of hemorrhagic complications after admission were compared between the ozagrel and control groups.
  
  
  RESULTS
  After the propensity score matching, 2726 pairs of patients with atherothrombotic stroke and 1612 pairs of patients with lacunar infarction were analyzed. Ordinal logistic regression analyses showed that ozagrel use was not significantly associated with modified Rankin Scale score at discharge in patients with atherothrombotic stroke (odds ratio: .99; 95% confidence interval: .88-1.11) or in those with lacunar infarction (odds ratio: 1.00; 95% confidence interval: .87-1.16). The occurrence of hemorrhagic complications did not differ significantly between the ozagrel and control groups.
  
  
  CONCLUSIONS
  The present study suggested that ozagrel was safe to use but did not improve functional outcomes in patients with atherothrombotic or lacunar infarction.
authors: Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan. Electronic address: wadat-eme@h.u-tokyo.ac.jp.
authors: Tomoki
authors: T
authors: Wada
authors: Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan.
authors: Hideo
authors: H
authors: Yasunaga
authors: Department of Clinical Data Management and Research, Clinical Research Center, National Hospital Organization Headquarters, Tokyo, Japan.
authors: Hiromasa
authors: H
authors: Horiguchi
authors: Department of Health Care Informatics, Tokyo Medical and Dental University, Tokyo, Japan.
authors: Kiyohide
authors: K
authors: Fushimi
authors: Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan.
authors: Takehiro
authors: T
authors: Matsubara
authors: Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan.
authors: Susumu
authors: S
authors: Nakajima
authors: Department of Emergency and Critical Care Medicine, The University of Tokyo Hospital, Tokyo, Japan.
authors: Naoki
authors: N
authors: Yahagi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D004791:Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D016015:Logistic Models; D008297:Male; D016555:Matched-Pair Analysis; D008689:Methacrylates / Q000009:adverse effects / Q000627:therapeutic use*; D008875:Middle Aged; D010351:Patient Discharge; D057216:Propensity Score; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D059409:Stroke, Lacunar / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D013930:Thromboxane-A Synthase / Q000037:antagonists & inhibitors* / Q000378:metabolism; D016896:Treatment Outcome
chemical_list: D004791:Enzyme Inhibitors; D008689:Methacrylates; D013930:Thromboxane-A Synthase; C034364:ozagrel
keywords: Diagnosis Procedure Combination database; Ischemic stroke; antiplatelet therapy; ozagrel; propensity score matching; stroke recurrence