{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T19:16:25Z","timestamp":1769109385228,"version":"3.49.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T00:00:00Z","timestamp":1604534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T00:00:00Z","timestamp":1604534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004609","name":"Foundation of Henan Educational Committee","doi-asserted-by":"crossref","award":["17A320060"],"award-info":[{"award-number":["17A320060"]}],"id":[{"id":"10.13039\/501100004609","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["81571158"],"award-info":[{"award-number":["81571158"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Dual antiplatelet therapy (DAPT) reduced stroke risk in high-risk transient ischemic attack (TIA) patients assessed by ABCD2 score. Patients with positive diffusion-weighted imaging (DWI) were identified as imaging-based high-risk. The present study aims to investigate whether DAPT could reduce stroke risk in TIA with DWI positive. The study enrolled TIA patients within 72\u00a0h of onset from the prospective TIA database of the First Affiliated Hospital of Zhengzhou University. The predictive outcome was ischemic stroke at 90-day. The relationship between DAPT and stroke was analyzed in a cox proportional hazards model. The Kaplan\u2013Meier curves of TIA patients with DAPT and monotherapy were plotted. Total of 661 TIA patients were enrolled, 279 of whom were DWI positive and 281 used DAPT. The 90-day stroke risk was higher in patients used monotherapy than those used DAPT in TIA with positive DWI (23.7% vs. 13.4%, <jats:italic>p<\/jats:italic>\u2009=\u20090.029). DAPT was associated with reduced stroke risk in TIA patients with positive DWI (hazard ratio [HR]\u2009=\u20090.54; 95% confidence interval [CI], 0.30\u20130.97; <jats:italic>p<\/jats:italic>\u2009=\u20090.037). However, the benefit didn\u2019t exist in TIA patients with negative DWI (HR\u2009=\u20090.43; 95% CI, 0.14\u20131.33; <jats:italic>p<\/jats:italic>\u2009=\u20090.142). Early use of DAPT reduced stroke risk in TIA patients with positive DWI.<\/jats:p>","DOI":"10.1038\/s41598-020-75666-6","type":"journal-article","created":{"date-parts":[[2020,11,5]],"date-time":"2020-11-05T11:03:19Z","timestamp":1604574199000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Dual antiplatelet therapy reduced stroke risk in transient ischemic attack with positive diffusion weighted imaging"],"prefix":"10.1038","volume":"10","author":[{"given":"Lu-lu","family":"Pei","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Fang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Cao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-nan","family":"Guo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jun","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shi-lei","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiao-ying","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eng H.","family":"Lo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ferdinando S.","family":"Buonanno","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming-ming","family":"Ning","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-ming","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bo","family":"Song","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,11,5]]},"reference":[{"key":"75666_CR1","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1056\/NEJMoa1800410","volume":"379","author":"SC Johnston","year":"2018","unstructured":"Johnston, S. C. et al. Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA. N. Engl. J. Med. 379, 215\u2013225. https:\/\/doi.org\/10.1056\/NEJMoa1800410 (2018).","journal-title":"N. Engl. J. Med."},{"key":"75666_CR2","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1056\/NEJMoa1215340","volume":"369","author":"Y Wang","year":"2013","unstructured":"Wang, Y. et al. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N. Engl. J. Med. 369, 11\u201319. https:\/\/doi.org\/10.1056\/NEJMoa1215340 (2013).","journal-title":"N. Engl. J. Med."},{"key":"75666_CR3","doi-asserted-by":"publisher","first-page":"1612","DOI":"10.1007\/s00415-016-8181-5","volume":"263","author":"X Yi","year":"2016","unstructured":"Yi, X. et al. Antiplatelet drug resistance is associated with early neurological deterioration in acute minor ischemic stroke in the Chinese population. J. Neurol. 263, 1612\u20131619. https:\/\/doi.org\/10.1007\/s00415-016-8181-5 (2016).","journal-title":"J. Neurol."},{"key":"75666_CR4","doi-asserted-by":"publisher","first-page":"961","DOI":"10.1016\/S1474-4422(07)70250-8","volume":"6","author":"J Kennedy","year":"2007","unstructured":"Kennedy, J. et al. Fast assessment of stroke and transient ischaemic attack to prevent early recurrence (FASTER): a randomised controlled pilot trial. Lancet Neurol. 6, 961\u2013969. https:\/\/doi.org\/10.1016\/S1474-4422(07)70250-8 (2007).","journal-title":"Lancet Neurol."},{"key":"75666_CR5","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1111\/ijs.12129","volume":"8","author":"SC Johnston","year":"2013","unstructured":"Johnston, S. C. et al. Platelet-oriented inhibition in new TIA and minor ischemic stroke (POINT) trial: rationale and design. Int. J. Stroke 8, 479\u2013483. https:\/\/doi.org\/10.1111\/ijs.12129 (2013).","journal-title":"Int. J. Stroke"},{"key":"75666_CR6","doi-asserted-by":"publisher","first-page":"572","DOI":"10.1001\/jamaneurol.2015.4906","volume":"73","author":"S Yaghi","year":"2016","unstructured":"Yaghi, S. et al. Imaging parameters and recurrent cerebrovascular events in patients with minor stroke or transient ischemic attack. JAMA Neurol. 73, 572\u2013578. https:\/\/doi.org\/10.1001\/jamaneurol.2015.4906 (2016).","journal-title":"JAMA Neurol."},{"key":"75666_CR7","doi-asserted-by":"publisher","first-page":"1244","DOI":"10.1161\/STROKEAHA.113.000969","volume":"44","author":"B Song","year":"2013","unstructured":"Song, B. et al. Validation of the ABCD3-I score to predict stroke risk after transient ischemic attack. Stroke 44, 1244\u20131248. https:\/\/doi.org\/10.1161\/STROKEAHA.113.000969 (2013).","journal-title":"Stroke"},{"key":"75666_CR8","doi-asserted-by":"publisher","DOI":"10.1007\/s12975-019-00769-w","author":"X Wang","year":"2020","unstructured":"Wang, X. et al. The association between serum apelin-13 and the prognosis of acute ischemic stroke. Transl. Stroke Res. https:\/\/doi.org\/10.1007\/s12975-019-00769-w (2020).","journal-title":"Transl. Stroke Res."},{"key":"75666_CR9","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1038\/s41598-018-36986-w","volume":"9","author":"B Song","year":"2019","unstructured":"Song, B. et al. Efficacy of high-intensity statin use for transient ischemic attack patients with positive diffusion-weighted imaging. Sci. Rep. 9, 1173. https:\/\/doi.org\/10.1038\/s41598-018-36986-w (2019).","journal-title":"Sci. Rep."},{"key":"75666_CR10","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1016\/S1474-4422(16)30236-8","volume":"15","author":"PJ Kelly","year":"2016","unstructured":"Kelly, P. J. et al. Validation and comparison of imaging-based scores for prediction of early stroke risk after transient ischaemic attack: a pooled analysis of individual-patient data from cohort studies. Lancet Neurol. 15, 1238\u20131247. https:\/\/doi.org\/10.1016\/S1474-4422(16)30236-8 (2016).","journal-title":"Lancet Neurol."},{"key":"75666_CR11","first-page":"541","volume":"54","author":"S Hatano","year":"1976","unstructured":"Hatano, S. Experience from a multicentre stroke register: a preliminary report. Bull. World Health Organ. 54, 541\u2013553 (1976).","journal-title":"Bull. World Health Organ."},{"key":"75666_CR12","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1161\/01.str.24.1.35","volume":"24","author":"HP Adams Jr","year":"1993","unstructured":"Adams, H. P. Jr. et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in acute stroke treatment. Stroke 24, 35\u201341. https:\/\/doi.org\/10.1161\/01.str.24.1.35 (1993).","journal-title":"Stroke"},{"key":"75666_CR13","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1056\/NEJM199108153250701","volume":"325","author":"North American Symptomatic Carotid Endarterectomy Trial, C","year":"1991","unstructured":"North American Symptomatic Carotid Endarterectomy Trial, C. Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. N. Engl. J. Med. 325, 445\u2013453. https:\/\/doi.org\/10.1056\/NEJM199108153250701 (1991).","journal-title":"N. Engl. J. Med."},{"key":"75666_CR14","doi-asserted-by":"publisher","first-page":"1426","DOI":"10.1212\/WNL.0000000000001444","volume":"84","author":"Q Dai","year":"2015","unstructured":"Dai, Q. et al. From clinical to tissue-based dual TIA: validation and refinement of ABCD3-I score. Neurology 84, 1426\u20131432. https:\/\/doi.org\/10.1212\/WNL.0000000000001444 (2015).","journal-title":"Neurology"},{"key":"75666_CR15","doi-asserted-by":"publisher","first-page":"1222","DOI":"10.1212\/WNL.0b013e3182309f91","volume":"77","author":"MF Giles","year":"2011","unstructured":"Giles, M. F. et al. (2011) Early stroke risk and ABCD2 score performance in tissue- vs time-defined TIA: a multicenter study. Neurology 77, 1222\u20131228. https:\/\/doi.org\/10.1212\/WNL.0b013e3182309f91 (2011).","journal-title":"Neurology"},{"key":"75666_CR16","doi-asserted-by":"publisher","first-page":"2110","DOI":"10.1016\/j.jstrokecerebrovasdis.2015.05.016","volume":"24","author":"S Anticoli","year":"2015","unstructured":"Anticoli, S. et al. Transient ischemic attack fast-track and long-term stroke risk: role of diffusion-weighted magnetic resonance imaging. J. Stroke Cerebrovasc. Dis. 24, 2110\u20132116. https:\/\/doi.org\/10.1016\/j.jstrokecerebrovasdis.2015.05.016 (2015).","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"75666_CR17","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1212\/WNL.0000000000001780","volume":"85","author":"JM Wardlaw","year":"2015","unstructured":"Wardlaw, J. M. et al. ABCD2 score and secondary stroke prevention: meta-analysis and effect per 1,000 patients triaged. Neurology 85, 373\u2013380. https:\/\/doi.org\/10.1212\/WNL.0000000000001780 (2015).","journal-title":"Neurology"},{"key":"75666_CR18","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1161\/STROKEAHA.113.003077","volume":"45","author":"T Kiyohara","year":"2014","unstructured":"Kiyohara, T. et al. ABCD3 and ABCD3-I scores are superior to ABCD2 score in the prediction of short- and long-term risks of stroke after transient ischemic attack. Stroke 45, 418\u2013425. https:\/\/doi.org\/10.1161\/STROKEAHA.113.003077 (2014).","journal-title":"Stroke"},{"key":"75666_CR19","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1161\/STROKEAHA.108.515817","volume":"40","author":"D Calvet","year":"2009","unstructured":"Calvet, D. et al. DWI lesions and TIA etiology improve the prediction of stroke after TIA. Stroke 40, 187\u2013192. https:\/\/doi.org\/10.1161\/STROKEAHA.108.515817 (2009).","journal-title":"Stroke"},{"key":"75666_CR20","doi-asserted-by":"publisher","first-page":"1656","DOI":"10.1161\/CIRCULATIONAHA.113.003187","volume":"128","author":"KS Wong","year":"2013","unstructured":"Wong, K. S. et al. Early dual versus mono antiplatelet therapy for acute non-cardioembolic ischemic stroke or transient ischemic attack: an updated systematic review and meta-analysis. Circulation 128, 1656\u20131666. https:\/\/doi.org\/10.1161\/CIRCULATIONAHA.113.003187 (2013).","journal-title":"Circulation"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-75666-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-75666-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-75666-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,6]],"date-time":"2022-12-06T22:36:49Z","timestamp":1670366209000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-020-75666-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,11,5]]},"references-count":20,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["75666"],"URL":"https:\/\/doi.org\/10.1038\/s41598-020-75666-6","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,11,5]]},"assertion":[{"value":"4 December 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 October 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 November 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"19132"}}