Safety of Dual Antiplatelet Therapy with Argatroban in Patients with Acute Ischemic Stroke Yoshinari Nagakane 1 , Eijirou Tanaka 1 , Shinji Ashida 1 , Yuta Kojima 1 , Shiori Ogura 1 , Keiko Maezono 1 , Yasumasa Yamamoto 1,2 1Department of Neurology, Kyoto Second Red Cross Hospital 2Department of Neurology, Kyoto Katsura Hospital Keyword: 脳梗塞 , 分枝アテローム血栓症 , アテローム血栓性梗塞 , 抗血小板薬2剤併用療法 , 抗凝固療法 , brain infarction , branch atheromatous disease , atherothrombotic infarction , dual antiplatelet therapy , anticoagulant therapy pp.557-562
Published Date 2018/5/1
DOI https://doi.org/10.11477/mf.1416201038
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To prevent early neurological worsening or recurrence in stroke patients with intracranial arterial stenosis or branch atheromatous disease, aggressive antithrombotic therapy, such as dual antiplatelet therapy (DAPT) with or without anticoagulant therapy, is warranted. Such an aggressive antithrombotic therapy, however, may increase the bleeding risk. We studied the risks of DAPT with the anticoagulant argatroban in patients with acute ischemic stroke or transient ischemic attack (TIA). Between October 2011 and September 2015, 341 patients with stroke or TIA, who received DAPT with argatroban within 48 hours after onset, were retrospectively studied. The endpoint was any bleeding event during hospitalization or 30 days after admission. Median duration of DAPT was 12 days, and 66% of the patients received intravenous heparin (median duration, 5 days) following argatroban. No symptomatic intracerebral hemorrhages were observed, while severe, moderate, and mild extracranial hemorrhages occured in one (0.3%), three (0.9%), and four (1.2%) patients, respectively. In conclusion, DAPT with argatroban can be safely administered to patients with acute ischemic stroke or TIA.

(Received July 24, 2017; Accepted January 15, 2018; Published May 1, 2018)

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