Effectiveness and safety of dual antiplatelet therapy in patients with minor ischemic stroke or transient ischemic attack and cancer: A secondary analysis of the READAPT study Article Swipe
Matteo Foschi
,
Federico De Santis
,
Lucio D’Anna
,
Michele Romoli
,
Tiziana Tassinari
,
Valentina Saia
,
Silvia Cenciarelli
,
Chiara Bedetti
,
Chiara Padiglioni
,
Bruno Censori
,
Valentina Puglisi
,
Luisa Vinciguerra
,
Maria Guarino
,
Valentina Barone
,
Marialuisa Zedde
,
Ilaria Grisendi
,
Marina Diomedi
,
Maria Rosaria Bagnato
,
Marco Petruzzellis
,
Domenico Maria Mezzapesa
,
Vincenzo Inchingolo
,
Manuel Cappellari
,
Cecilia Zivelonghi
,
Paolo Candelaresi
,
Vincenzo Andreone
,
Giuseppe Rinaldi
,
Alessandra Bavaro
,
Anna Cavallini
,
Maria Grazia Piscaglia
,
Valeria Terruso
,
Marina Mannino
,
Alessandro Pezzini
,
Giovanni Frisullo
,
Francesco Muscia
,
Maurizio Paciaroni
,
Maria Giulia Mosconi
,
Andrea Zini
,
Ruggiero Leone
,
Carmela Palmieri
,
Letizia Maria Cupini
,
Michela Marcon
,
Rossana Tassi
,
Enzo Sanzaro
,
Giulio Papiri
,
Giovanna Viticchi
,
Daniele Orsucci
,
Anne Falcou
,
Susanna Diamanti
,
Roberto Tarletti
,
Patrizia Nencini
,
Eugenia Rota
,
Federica Nicoletta Sepe
,
Delfina Ferrandi
,
Luigi Caputi
,
Gino Volpi
,
Salvatore Laspada
,
Mario Beccia
,
Claudia Rinaldi
,
Vincenzo Mastrangelo
,
Francesco Di Blasio
,
Paolo Invernizzi
,
Giuseppe Pelliccioni
,
Maria Vittoria De Angelis
,
Laura Bonanni
,
Giampietro Ruzza
,
Emanuele Alessandro Caggia
,
Monia Russo
,
Agnese Tonon
,
Maria Cristina Acciarri
,
Sabrina Anticoli
,
Cinzia Roberti
,
Giovanni Manobianca
,
Gaspare Scaglione
,
Francesca Pistoia
,
Alberto Fortini
,
Antonella Boni
,
Alessandra Sanna
,
Alberto Chiti
,
Marcella Caggiula
,
Maela Masato
,
Massimo Del Sette
,
Francesco Passarelli
,
Maria Roberta Bongioanni
,
Manuela De Michele
,
Stefano Ricci
,
Eleonora De Matteis
,
Raffaele Ornello
,
Simona Sacco
·
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1177/23969873251333282
YOU?
·
· 2025
· Open Access
·
· DOI: https://doi.org/10.1177/23969873251333282
Introduction: Patients with ischemic stroke or transient ischemic attack (TIA) and cancer face unique risks of recurrent ischemic events and bleeding. It is unclear whether this increased risk is present even in patients with minor ischemic stroke or transient ischemic attack (TIA) receiving dual antiplatelet therapy (DAPT). This study aimed to evaluate the impact of cancer on the short-term outcomes after DAPT in patients with non-cardioembolic minor ischemic stroke or high-risk TIA. Patients and methods: This was a secondary analysis of the prospective multicentric READAPT study (NCT05476081), including patients with non-cardioembolic minor ischemic stroke (NIHSS ⩽ 5) or high-risk TIA (ABCD2 ⩾4) who initiated DAPT within 48 h of symptom onset. The primary effectiveness outcome was the 90-day risk of new ischemic stroke or other vascular events (TIA, myocardial infarction, death due to vascular causes). Secondary outcomes included 90-day mRS score distribution and all-cause mortality. The primary safety outcome was the 90-day risk of any bleeding, with secondary safety outcomes including 24-h hemorrhagic transformation. We used Inverse Probability Weighting to compare outcomes between patients with and without cancer. Results: From 2278 patients in the READAPT study cohort, we included 1561 patients (mean age 70.3 ± 11.7 years; 65.4% males), of whom 206 (13.2%) had cancer, categorized as either active (27.7%) or in remission (72.3%). After weighting, overall cancer patients had a higher risk of 90-day new ischemic stroke or other vascular events (weighted HR 1.78, 95% CI 1.20–2.63, p = 0.004) and worse 90-day mRS score distribution (OR 1.24, 95% CI 1.10–1.41, p < 0.001) compared to patients without cancer. The 90-day risk of bleeding did not differ between cancer and no-cancer groups overall. When analyzing cancer subgroups, patients with active cancer had significantly higher risk of 90-day ischemic stroke or other vascular (weighted HR 2.75, 95% CI 1.70–4.45, p < 0.001) and any bleeding (weighted HR 2.51, 95% CI 1.27–4.97, p = 0.008) events compared to no-cancer patients. In contrast, patients with cancer in remission had comparable risks to those without cancer. Furthermore, hematological malignancies were associated with a substantially higher risk of 90-day new ischemic stroke or other vascular events compared to solid tumors (weighted HR 8.15, 95% CI 5.06–13.14, p < 0.001). Conclusions: Patients with minor ischemic stroke or high-risk TIA and active cancer have increased risk of ischemic and bleeding events after DAPT. Conversely, patients with cancer in remission have similar outcomes compared to those with no cancer.
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- Type
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- Language
- en
- Landing Page
- https://doi.org/10.1177/23969873251333282
- OA Status
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- References
- 31
- Related Works
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- OpenAlex ID
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https://openalex.org/W4409703535Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1177/23969873251333282Digital Object Identifier
- Title
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Effectiveness and safety of dual antiplatelet therapy in patients with minor ischemic stroke or transient ischemic attack and cancer: A secondary analysis of the READAPT studyWork title
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2025Year of publication
- Publication date
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2025-04-23Full publication date if available
- Authors
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Matteo Foschi, Federico De Santis, Lucio D’Anna, Michele Romoli, Tiziana Tassinari, Valentina Saia, Silvia Cenciarelli, Chiara Bedetti, Chiara Padiglioni, Bruno Censori, Valentina Puglisi, Luisa Vinciguerra, Maria Guarino, Valentina Barone, Marialuisa Zedde, Ilaria Grisendi, Marina Diomedi, Maria Rosaria Bagnato, Marco Petruzzellis, Domenico Maria Mezzapesa, Vincenzo Inchingolo, Manuel Cappellari, Cecilia Zivelonghi, Paolo Candelaresi, Vincenzo Andreone, Giuseppe Rinaldi, Alessandra Bavaro, Anna Cavallini, Maria Grazia Piscaglia, Valeria Terruso, Marina Mannino, Alessandro Pezzini, Giovanni Frisullo, Francesco Muscia, Maurizio Paciaroni, Maria Giulia Mosconi, Andrea Zini, Ruggiero Leone, Carmela Palmieri, Letizia Maria Cupini, Michela Marcon, Rossana Tassi, Enzo Sanzaro, Giulio Papiri, Giovanna Viticchi, Daniele Orsucci, Anne Falcou, Susanna Diamanti, Roberto Tarletti, Patrizia Nencini, Eugenia Rota, Federica Nicoletta Sepe, Delfina Ferrandi, Luigi Caputi, Gino Volpi, Salvatore Laspada, Mario Beccia, Claudia Rinaldi, Vincenzo Mastrangelo, Francesco Di Blasio, Paolo Invernizzi, Giuseppe Pelliccioni, Maria Vittoria De Angelis, Laura Bonanni, Giampietro Ruzza, Emanuele Alessandro Caggia, Monia Russo, Agnese Tonon, Maria Cristina Acciarri, Sabrina Anticoli, Cinzia Roberti, Giovanni Manobianca, Gaspare Scaglione, Francesca Pistoia, Alberto Fortini, Antonella Boni, Alessandra Sanna, Alberto Chiti, Marcella Caggiula, Maela Masato, Massimo Del Sette, Francesco Passarelli, Maria Roberta Bongioanni, Manuela De Michele, Stefano Ricci, Eleonora De Matteis, Raffaele Ornello, Simona SaccoList of authors in order
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https://www.ncbi.nlm.nih.gov/pmc/articles/12018360Direct OA link when available
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Medicine, Stroke (engine), Internal medicine, Minor stroke, Myocardial infarction, Cancer, Prospective cohort study, Cardiology, Surgery, Stenosis, Engineering, Mechanical engineeringTop concepts (fields/topics) attached by OpenAlex
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0Total citation count in OpenAlex
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31Number of works referenced by this work
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10Other works algorithmically related by OpenAlex
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