The Analysis Of Risk Factors And The Outcomes Of Dual Antiplatelet Therapy On The CISS Type Of Acute Minor Stroke

Objective: To investigate the risk factors of acute ischemic minor stroke in the etiology of CISS classification,and observe the treatment efficacy of clopidogrel with Aspirin.Methods:1 Selected the patients of acute ischemic minor stroke between January 2015 and January 2016 admitted to our department.According to the CISS,the patients divided into two groups randomly as perforating artery disease group and large artery atherosclerosis group.2 Reviewed the history of hypertension,diabetes,hyperlipidemia,and recorded the age,gender,and common risk factors of the patients.Then,the difference between the two groups were compared.3 All patients received the treatment as same as the CHANCE study(the combination of clopidogrel and aspirin).The onset of the primary outcomes(ischemic and hemorrhagic stroke),secondary outcomes(myocardial infarction,vascular death,microhemorrhage,the occurrence of TIA),safety endpoints(moderate and severe hemorrhagic events),and prognosis of patients after 3 months were recorded and analyzed.Results: 100 cases of minor stroke patients were studied,which containing 50 cases of large artery atherosclerosis and 50 cases of perforating artery disease group.All patients were confirmed by the DWI imaging.Single factor analysis showed that the age,hyperlipidemia smoking were different between the large artery atherosclerosis group and the perforating artery disease,and the differences between the two groups were statistically significance.The onset of the primary outcomes:after treatment with aspirin plus clopidogrel,the incidence rate of recurrent stroke(including ischemic stroke and bleeding stroke)in large artery atherosclerosis group(6%)was lower than the perforating artery disease group(20%).The safety endpoints: among the large artery atherosclerosis group,there were 7 cases of hemorrhagic events,including 6 cases of microbleeds and 1 case of moderate bleeding.And,among the perforating artery disease group,there were 9 cases of hemorrhagic events,including 5 cases of microbleeds,3 cases of moderate hemorrhage,and 1 case severe bleeding.The difference of hemorrhagic events between the two groups was not statistically significant.The prognosis of patients after 3 months: there was 1 case with unfavourable prognosis in the large artery atherosclerosis group,while 4 cases in the perforating artery disease group,the differences between the two groups were not statistically significance.Conclusion:1There are differences with age,diabetes,hyperlipidemia,smoking between the large artery atherosclerosis type and the perforating artery disease type.2 It is better to prevent the recurrent stroke for the large artery atherosclerosis type than the perforating artery disease type when applicating clopidogrel combined with aspirin.3 There are clinical significance on assessment of risk factors and treatment with the CISS typing of minor stroke.