Aspirin-Dipyridamole in Fluctuating Small Vessel Disease Ischemic Strokes
Caitlin Moran1, Katherine March2, Katherine Nearing1
1Neurology, University of Tennessee Health Science Center, 2Methodist University Hospital
Objective:
Short-term inpatient use of aspirin-dipyridamole (Aggrenox) in small vessel disease (SVD) ischemic strokes (IS) may reduce neurologic fluctuations, leading to better functional outcomes. This single-center retrospective case-control study aims to compare outcomes in patients diagnosed with SVD IS who received Aggrenox versus standard antiplatelet therapy.
Background:

Aggrenox is a fixed-dose combination of aspirin, an antiplatelet, and extended-release dipyridamole, which acts both to impair platelet function and cause vasodilation. Previous studies showed Aggrenox to be safe and effective for secondary stroke prevention. We suspect that early use of Aggrenox could be effective for stroke prevention and functional outcomes due to its vasodilatory properties.

Design/Methods:

A retrospective analysis of patients diagnosed with SVD IS between January 2016-December 2020 was completed. We plan to enroll patients admitted through September 2022. Patients with age ≥18, who received a minimum of four doses of Aggrenox during hospitalization, will be matched with control patients who did not receive Aggrenox. Study end points include discharge NIHSS compared hospital day 1 and discharge mRS compared to admission. REDCap is being used for data collection and generation of descriptive statistics.

Results:

Thus far, 49 patients have qualified for inclusion into the Aggrenox cohort, with data collection still in progress. Subject pool has mean age 55; 49% male; 82% African American; 49% diabetic; 37% received tPA; mean length of time from admission to administration of Aggrenox of 26 hours; mean duration of Aggrenox 4 days; mean NIHSS on admission 5.7; mean NIHSS on discharge 5.1; mean mRS at admission 0.6; mean mRS at discharge 2.7; 41% of patients discharged home, 57% to inpatient rehabilitation, and 2% to a skilled nursing facility.

Conclusions:

Data in the Aggrenox population shows a trend toward improvement in NIHSS throughout hospitalization. Once control group data is collected, comparative statistics will be used to analyze outcomes between the two groups.

10.1212/WNL.0000000000203581