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For children with arterial ischemic stroke: antithrombotic regimens are associated with disease subtypes


A study by American scholar shows that the use of antithrombotic therapy for arterial ischemic stroke (AIS) is more common, but clinical treatment regimens vary according to AIS subtype and regional differences; several factors predict early AIS Outcome, but also the need for clinical trials to determine the best treatment. Related papers published on October 5, 2009 online "Lancet Neurology" (Lancet Neurol).

The investigators analyzed the standardized case reports of 661 AIS children (aged 28 to 19 years) from 33 centers between January 1, 2007 and October 1, 2007.

The results showed that 640 cases of children with acute treatment data, 612 cases of children with morbidity data, 643 cases of children with mortality data. In the acute phase of treatment, 171 (27%) children received anticoagulation alone, 177 patients (28%) received antiplatelet therapy alone, and 103 patients (16%) received anticoagulation And antiplatelet therapy, 189 patients (30%) did not receive antithrombotic therapy. The AIS subtype associated with anticoagulation therapy was associated with arterial dissection (P <0.0001) and heart disease (P = 0.01) after adjustment for significant covariates; factors associated with no anticoagulation therapy were sickle cell anemia (P = 0.04) and included data from the United States (P = 0.002). In contrast, antiplatelet therapy was associated with moyamoya disease (P = 0.0002), whereas no antiplatelet therapy was associated with arterial dissection (P = 0.047), ambiguity (P <0.0001) and bilateral ischemia (P <0.0001 ). Forty-five (74%) children had neurological deficits and 22 (3%) had died. Multivariate analysis showed that patients with arterial disease, bilateral ischemia and disturbance of consciousness indicated poor prognosis.

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