Aging · 2020
Combined impact of body mass index and glycemic control on the efficacy of clopidogrel-aspirin therapy in patients with minor stroke or transient ischemic attack.
Клиническое исследование III фазыСтатьяМногоцентровое исследованиеРандомизированное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Chen Zimo, Mo Jinglin, Xu Jie, Wang Anxin, Qin Haiqiang, Zheng Huaguang, Liu Liping, Meng Xia, Li Hao, Wang Yongjun
Аннотация
BACKGROUND: A single index of body mass index (BMI) may not fully address its impact on anti-platelet therapy. We aimed to elucidate the combined impact of BMI and dysglycemia expressed by glycated albumin (GA) on efficacy of clopidogrel-aspirin therapy among minor stroke (MS) or transient ischemic attack (TIA) patients.
RESULTS: Patients with overweight/obesity and low GA levels still benefited from clopidogrel-aspirin therapy for stroke recurrence (Hazard ratio [HR]: 0.48, 95 % confidence interval [CI]: 0.28-0.82), so did those with high GA levels but low/normal weight (HR: 0.67, 95 % CI: 0.45-0.99). However, patients with both overweight/obesity and high GA levels did not benefit from clopidogrel-aspirin therapy (HR: 0.89, 95 % CI: 0.59-1.33).
CONCLUSIONS: Compared with aspirin alone, efficacy of clopidogrel-aspirin therapy for stroke still exists in overweight/obesity patients with normal glycemic control.
METHODS: In Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events trial, 3044 patients with available baseline GA were recruited. Low/normal weight and overweight/obesity were defined as BMI < 25 kg/m2 and ≥ 25 kg/m2, respectively. Elevated and low GA levels were defined as GA levels > 15.5 % and ≤ 15.5 %, respectively. The primary outcome was stroke recurrence during the 90-day follow-up.
RESULTS: Patients with overweight/obesity and low GA levels still benefited from clopidogrel-aspirin therapy for stroke recurrence (Hazard ratio [HR]: 0.48, 95 % confidence interval [CI]: 0.28-0.82), so did those with high GA levels but low/normal weight (HR: 0.67, 95 % CI: 0.45-0.99). However, patients with both overweight/obesity and high GA levels did not benefit from clopidogrel-aspirin therapy (HR: 0.89, 95 % CI: 0.59-1.33).
CONCLUSIONS: Compared with aspirin alone, efficacy of clopidogrel-aspirin therapy for stroke still exists in overweight/obesity patients with normal glycemic control.
METHODS: In Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events trial, 3044 patients with available baseline GA were recruited. Low/normal weight and overweight/obesity were defined as BMI < 25 kg/m2 and ≥ 25 kg/m2, respectively. Elevated and low GA levels were defined as GA levels > 15.5 % and ≤ 15.5 %, respectively. The primary outcome was stroke recurrence during the 90-day follow-up.
Предметные рубрики MeSH
AgedAspirinBody Mass IndexClopidogrelDose-Response Relationship, DrugDrug Administration ScheduleDrug Therapy, CombinationFemaleFollow-Up StudiesGlycation End Products, AdvancedGlycemic ControlHumansIschemic Attack, TransientMaleMiddle AgedObesityOverweightPlatelet Aggregation InhibitorsRecurrenceSerum AlbuminStrokeTreatment OutcomeGlycated Serum Albumin