Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease

Abstract Revascularization surgery is considered a standard treatment for preventing additional stroke in symptomatic moyamoya disease (MMD). In hemodynamically stable, and asymptomatic or mildly symptomatic patients, however, the treatment strategy is controversial because of the obscure natural co...

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Autores principales:	Chang Hwan Pang, Won-Sang Cho, Hyun-Seung Kang, Jeong Eun Kim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/fd256a1518764bd19fecd83a1e8300f6
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spelling	oai:doaj.org-article:fd256a1518764bd19fecd83a1e8300f62021-12-02T18:51:07ZBenefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease10.1038/s41598-021-99009-12045-2322https://doaj.org/article/fd256a1518764bd19fecd83a1e8300f62021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-99009-1https://doaj.org/toc/2045-2322Abstract Revascularization surgery is considered a standard treatment for preventing additional stroke in symptomatic moyamoya disease (MMD). In hemodynamically stable, and asymptomatic or mildly symptomatic patients, however, the treatment strategy is controversial because of the obscure natural course of them. The authors analyzed the benefits and risks of antiplatelet medication in those patients. Medical data were retrospectively reviewed in 439 hemispheres of 243 patients with stable hemodynamic status. Overall, 121 patients (49.8%) with 222 studied hemispheres (50.6%) took antiplatelet medication. Symptomatic cerebral infarction and hemorrhage occurred in 10 (2.3%) and 30 (6.8%) hemispheres, over a mean follow-up of 62.0 ± 43.4 months (range 6–218 months). The use of antiplatelet agents was statistically insignificant in terms of symptomatic infarction, hemorrhage and improvement of ischemic symptoms. In subgroup analyses within the antiplatelet group according to drug potency and duration of medication, a longer duration of antiplatelet medication significantly improved ischemic symptoms (adjusted OR 1.02; 95% CI 1.01–1.03; p = 0.006). Antiplatelet medication failed to prevent symptomatic cerebral infarction or improve ischemic symptoms. However, antiplatelet therapy did not increase the risk of cerebral hemorrhage.Chang Hwan PangWon-Sang ChoHyun-Seung KangJeong Eun KimNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Chang Hwan Pang Won-Sang Cho Hyun-Seung Kang Jeong Eun Kim Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease
description	Abstract Revascularization surgery is considered a standard treatment for preventing additional stroke in symptomatic moyamoya disease (MMD). In hemodynamically stable, and asymptomatic or mildly symptomatic patients, however, the treatment strategy is controversial because of the obscure natural course of them. The authors analyzed the benefits and risks of antiplatelet medication in those patients. Medical data were retrospectively reviewed in 439 hemispheres of 243 patients with stable hemodynamic status. Overall, 121 patients (49.8%) with 222 studied hemispheres (50.6%) took antiplatelet medication. Symptomatic cerebral infarction and hemorrhage occurred in 10 (2.3%) and 30 (6.8%) hemispheres, over a mean follow-up of 62.0 ± 43.4 months (range 6–218 months). The use of antiplatelet agents was statistically insignificant in terms of symptomatic infarction, hemorrhage and improvement of ischemic symptoms. In subgroup analyses within the antiplatelet group according to drug potency and duration of medication, a longer duration of antiplatelet medication significantly improved ischemic symptoms (adjusted OR 1.02; 95% CI 1.01–1.03; p = 0.006). Antiplatelet medication failed to prevent symptomatic cerebral infarction or improve ischemic symptoms. However, antiplatelet therapy did not increase the risk of cerebral hemorrhage.
format	article
author	Chang Hwan Pang Won-Sang Cho Hyun-Seung Kang Jeong Eun Kim
author_facet	Chang Hwan Pang Won-Sang Cho Hyun-Seung Kang Jeong Eun Kim
author_sort	Chang Hwan Pang
title	Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease
title_short	Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease
title_full	Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease
title_fullStr	Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease
title_full_unstemmed	Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease
title_sort	benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/fd256a1518764bd19fecd83a1e8300f6
work_keys_str_mv	AT changhwanpang benefitsandrisksofantiplateletmedicationinhemodynamicallystableadultmoyamoyadisease AT wonsangcho benefitsandrisksofantiplateletmedicationinhemodynamicallystableadultmoyamoyadisease AT hyunseungkang benefitsandrisksofantiplateletmedicationinhemodynamicallystableadultmoyamoyadisease AT jeongeunkim benefitsandrisksofantiplateletmedicationinhemodynamicallystableadultmoyamoyadisease
_version_	1718377483054612480

Benefits and risks of antiplatelet medication in hemodynamically stable adult moyamoya disease

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