Discussion
thrombosis, bleeding, stroke, liver injury, neurological deficit, rupture, atrial fibrillation, platelet aggregation, diabetes
THROMBOSIS, BLEEDING, RECURRENCE, HYPERLIPIDEMIA, ADVERSE EVENTS, STROKE, PLAQUE, ATRIAL FIBRILLATION, HYPERTENSION, CEREBRAL INFARCTION, DIABETES
In this study, compared with rosuvastatin plus SAPT, the intensive rosuvastatin therapy plus 7-day DAPT significantly reduced the risk of recurrent stroke within 90 days for patients with mild to moderate AIS, without increasing adverse events, such as bleeding, statin-induced liver injury, or SAM. The reduction was particularly significant in the subgroups with high-risk factors (the elderly [> 68 years old], hypertension, diabetes, hyperlipidemia, prior-stroke, non-antiplatelet treatment, and high bNIHSS [3–10 points]), but not significant in female, OMT > 48 h, and prior atrial fibrillation subgroups. These results should be interpreted by considering the characteristics of the therapy regimens in this study, namely, the strong inhibition of platelet aggregation and reduction of thrombosis by DAPT and the multiple effects of intensive statin therapy.Previous study showed that statins, especially fat-soluble statins, commonly caused statin-induced liver injury and SAM, along with a three-fold or more increase in ALT, AST, or CK levels [In the elderly subgroup (> 68 years old), the study therapy reduced the risk of stroke recurrence more than the control therapy did, which may be related to elderly patients’ high risk of stroke [At the early stage of cerebral infarction, a large part of the brain tissue is still in the ischemic penumbra due to the incomplete rupture of the lipid plaque and relatively mild inflammatory storm [The NIHSS can not only quantify the symptoms and signs of focal neurological deficit [Many studies have shown that AIS patients with high-risk factors [Aspirin and clopidogrel are the most common antiplatelet drugs. Aspirin has an irreversible inhibitory effect on platelet aggregation through acetylated platelet cyclooxygenase, while clopidogrel, as an adenosine diphosphate receptor inhibitor, inhibits platelet aggregation. For patients who took antiplatelet agents regularly and still had AIS, the possible cause was aspirin resistance [