# Comparative Effectiveness of Dual Antiplatelet Therapy Versus Single Antiplatelet Therapy in Patients With Acute Stroke

## TL;DR

This study compared dual and single antiplatelet therapies in acute stroke patients but found no significant difference in outcomes like stroke recurrence or bleeding.

## Contribution

The study provides real-world evidence on the effectiveness of dual antiplatelet therapy in acute stroke patients in a specific geographic region.

## Key findings

- No significant difference in stroke recurrence, bleeding, or mortality between dual and single antiplatelet therapy.
- Former smoking, TIA history, and aspirin use were significant predictors of stroke recurrence.
- Dual antiplatelet therapy was not an independent predictor of improved outcomes.

## Abstract

This retrospective observational cohort study aimed to evaluate the comparative effectiveness of dual antiplatelet therapy (DAPT) versus single antiplatelet therapy (SAPT) in patients presenting with acute stroke at a tertiary care center in Muzaffarabad. A total of 250 patients aged 40-89 years (mean age=63.89; n=136; 54.4% female) were included, categorized into DAPT (n=129) or SAPT (n=121) groups. Baseline characteristics were evenly distributed, including hypertension (n=127; 50.8%), diabetes (n=120; 48%), and hyperlipidemia (n=124; 49.6%). The main outcome was recurrence of ischemic stroke within 90 days, confirmed by clinical assessment and neuroimaging (computed tomography (CT) or magnetic resonance imaging (MRI)). Secondary outcomes included any bleeding event (defined as documented clinical bleeding with no methodological categorization into major bleeding, minor bleeding, bleeding at a particular site, or bleeding by time), and mortality from any cause. The following medical comorbidities were recorded in patients: stroke in 133 (53.2%), bleeding in 131 (52.4%), and mortality in 127 (50.8%). Independent samples t-tests and chi-squared tests showed no significant difference in recurrence, bleeding, or mortality between treatment arms (p>0.05). Logistic regression indicated that former smoking (OR=0.331; p=0.003), transient ischemic attack (TIA) history (OR=1.884; p=0.031), and aspirin use (OR=0.468; p=0.012) were significant predictors of stroke recurrence. DAPT was not an independent predictor (p=0.583). These findings suggest that while DAPT may offer theoretical benefits, it was not significantly superior to SAPT in this cohort.