INFLUENCES OFDUALANTIPLATELETTHERAPYONNEUROLOGICALFUNCTION,HEMORHEOLOGY AND OUTCOMES IN PATIENTS WITH POSTERIOR CIRCULATION ISCHEMIC STROKE

Ya-Fei Wang1, #, Cai-Lian Ruan2, #, Shang-Jun Chen3, Teng-Bo Pei2, Zhi-Yong Liu2, Lu Wang2, Sheng-hai Wang2, hong-Rui Du4, *

1Department of Neurosurgery, Ningxia Hui Autonomous Region People’s Hospital, Ningxia Province 750021, China - 2Medical College of Yan’an University, Yan’an City, Shanxi Province 716000, China - 3Department of Neurosurgery, Shanxi Nuclear Industry 215 Hospital, Xianyang City, Shanxi Province 712000, China - 4Department of Neurosurgery, People’s Hospital of Yan’an in Shanxi Province, Yan’an City, Shanxi Province 716000, China

 Objective: To investigate the influences of dual antiplatelet therapy on neurological function, hemorheology and outcomes in patients with posterior circulation ischemic stroke (PCIS).

Methods: A total of 150 patients with PCIS in our hospital from May 2014 to May 2016 were selected and were divided randomly into a control group and an observation group, with 75 cases in each group. The patients in the two groups were given conventional therapy. The control group was given an aspirin anticoagulant therapy, and the observation group was given a dual antiplatelet therapy (aspirin and clopidogrel). National Institutes of Health Stroke Scale (NIHSS) scores, Alzheimer Disease Assessment Scale (ADAS- Cog) scores and changes in the hemorheology index in the two groups were compared. The differences in outcomes and adverse were observed.

Results: After treatment, the NIHSS scores (6.33±2.28) and the ADAS-Cog scores (34.71±5.49) in the observation group were significantly lower than the NIHSS scores (10.04±2.51) and the ADAS-Cog scores (42.83±5.52) in the control group, and the differenc- es were statistically significant (P < 0.05). After treatment, the levels of platelet (PLT) and fibrinogen (FIB), whole blood high-shear relative viscosity, whole blood low-shear relative viscosity, and plasma viscosity in the observation group were significantly lower than those in the control group (P < 0.05). After a 1-year follow-up, the recurrence rate in the observation group was significantly lower than that in the control group (P < 0.05). The disability and mortality in the observation group were slightly lower than those in the control group, but the difference was not statistically significant (P > 0.05); the total incidence of adverse reactions in the observation group was slightly higher than that in the control group (14.67% vs 12.00%), but there was no statistically significant difference (P >

0.05). Conclusion: Dual antiplatelet therapy can improve the neurological function of the patients with PCIS, has favorable outcomes and safety profiles, and is worthy of clinical application.