Antiplatelet use and CADASIL: a retrospective observational analysis.
Antiplatelet
CADASIL
Intracerebral hemorrhage
Ischemic Stroke
Journal
Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
ISSN: 1590-3478
Titre abrégé: Neurol Sci
Pays: Italy
ID NLM: 100959175
Informations de publication
Date de publication:
Aug 2023
Aug 2023
Historique:
received:
25
01
2023
accepted:
20
03
2023
medline:
17
7
2023
pubmed:
26
3
2023
entrez:
25
3
2023
Statut:
ppublish
Résumé
Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is hallmarked by age-dependent accumulation of microangiopathy with antiplatelet medications commonly used for stroke prevention though without known therapeutic benefit. Our objective was to identify whether antiplatelet therapy impacted the incidence of acute ischemic stroke (AIS) or intracerebral hemorrhage (ICH) in those with reported CADASIL. Owing to the rarity of the disease, we performed a retrospective study of anonymized data from the international TriNetX Research Network (Oct 2015 through January 2021). Individuals had an ICD-10 code (I67.850) for CADASIL. The primary outcome was incidence of validated ICD-10 codes for AIS (I63) and ICH (I61) linked with unique hospital admission encounters. The primary exposure was use of an antiplatelet medication for at least 1 month prior to the primary outcome. Age-adjusted logistic regression was used for likelihood ratios. We identified 455 individuals: 36% female, 40 (8.8%) antiplatelet exposed. Those with antiplatelet use were older (antiplatelet: 61±12 years vs. unexposed: 57±14 years, p = 0.034) with similar rates of AIS [antiplatelet: 23%(9/40) vs. unexposed: 14%(60/415); p=0.18] and ICH [antiplatelet: 3%(1/40) vs. unexposed: 5%(19/415); p = 0.54) and without significant impact on age-adjusted AIS likelihood (OR 1.62, 95%CI 0.73-3.60, p=0.23). Sample size precluded ICH regression analyses. Our data suggests that antiplatelet use did not significantly impact incidence of AIS or ICH within a group of individuals with suspected CADASIL This study highlights the need for further understanding of the pathophysiology of CADASIL to lead to disease modifying treatments.
Identifiants
pubmed: 36966219
doi: 10.1007/s10072-023-06773-1
pii: 10.1007/s10072-023-06773-1
doi:
Substances chimiques
Platelet Aggregation Inhibitors
0
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2831-2834Informations de copyright
© 2023. Fondazione Società Italiana di Neurologia.
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