Anzeige
Erschienen in:
27.04.2023 | Original Communication
Antiplatelet therapy may improve the prognosis of patients with moyamoya disease: a 12-year retrospective study
Erschienen in: Journal of Neurology | Ausgabe 8/2023
Einloggen, um Zugang zu erhaltenAbstract
Objectives
The clinical value of antiplatelet therapy (APT) for moyamoya disease (MMD) remains controversial. Our study attempts to clarify the value of APT in this disease.
Methods
We collected basic information, treatment strategies, and prognostic information on patients with MMD from 2010 to 2022 at our center. The data were divided into two groups, depending on whether APT was used or not, and compared by Pearson Chi-Square, Fisher’s exact test, or Wilcoxon rank-sum test. We used propensity scores or inverse probability of treatment weighting to balance the covariates. Following this, we performed a meta-analysis of APT use in MMD.
Results
177 patients were enrolled, with a median follow-up of 41.1 months. APT did not affect the prognosis of patients with perioperative MMD, ischemic MMD, or asymptomatic MMD (P > 0.05), without increasing cerebral hemorrhagic risk. In contrast, APT was found to reduce mortality among patients with hemorrhagic MMD (P = 0.019), without affecting functional status, increasing stroke risk, or causing intracerebral hemorrhage (P > 0.05). But the small group cannot show the effect of APT. Our meta-analysis included nine articles involving 28,925 patients with MMD. It showed that APT could reduce stroke risk (odds ratio, OR = 0.57, 95% CI 0.49 to 0.65) and the Modified Rankin Scale (mRS) (weighted mean difference, WMD = − 0.07, 95% CI 0.14–0.00) during follow-up. The cohort study has limited weight (1.97% and 19.29%) in the meta-analysis.
Conclusion
Although the limited number of included documents, APT could be beneficial to the prognosis of MMD.