{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:39:14Z","timestamp":1792787954981,"version":"4.5.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:00:00Z","timestamp":1697155200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:00:00Z","timestamp":1697155200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100011828","name":"Guangxi Zhuang Autonomous Region Health and Family Planning Commission","doi-asserted-by":"publisher","award":["Z-B20221499"],"award-info":[{"award-number":["Z-B20221499"]}],"id":[{"id":"10.13039\/501100011828","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Liuzhou Scientific Research Technological Development Programs","award":["2022CAC0118"],"award-info":[{"award-number":["2022CAC0118"]}]},{"name":"Liuzhou Scientific Research Technological Development Programs","award":["2022CAC0118"],"award-info":[{"award-number":["2022CAC0118"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Neurol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>For ischaemic stroke patients with gastrointestinal haemorrhage, stopping antiplatelet drugs or reducing the dose of antiplatelet drugs was a conventional clinical therapy method. But not a study to prove which way was better. And the machinery learning methods could help to obtain which way more suit for some patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from consecutive ischaemic stroke patients with gastrointestinal haemorrhage were prospectively collected. The outcome was a recurrent stroke rate, haemorrhage events, mortality and favourable functional outcome (FFO). We analysed the data using conventional logistic regression methods and a supervised machine learning model. We used unsupervised machine learning to group and analyse data characters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The patients of stopping antiplatelet drugs had a lower rate of bleeding events (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.125), mortality (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008), rate of recurrence of stroke (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.161) and distribution of severe patients (mRS 3\u20136) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.056). For Logistic regression, stopping antiplatelet drugs (OR\u2009=\u20092.826,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.030) was related to lower mortality. The stopping antiplatelet drugs in the supervised machine learning model related to mortality (AUC\u2009=\u20090.95) and FFO (AUC\u2009=\u20090.82). For group by unsupervised machine learning, the patients of better prognosis had more male (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), younger (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), had lower NIHSS score (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001); and had a higher value of serum lipid level (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>For ischemic stroke patients with gastrointestinal haemorrhage, stopping antiplatelet drugs had a better prognosis. Patients who were younger, male, with lesser NIHSS scores at admission, with the fewest history of a medical, higher value of diastolic blood pressure, platelet, blood lipid and lower INR could have a better prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12883-023-03422-0","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T04:02:57Z","timestamp":1697169777000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The machine learning methods to analyze the using strategy of antiplatelet drugs in ischaemic stroke patients with gastrointestinal haemorrhage"],"prefix":"10.1186","volume":"23","author":[{"given":"Chaohua","family":"Cui","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changhong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Hou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ping","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhonghua","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"3422_CR1","doi-asserted-by":"publisher","unstructured":"Powers. 2018 Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association\/American Stroke Association (vol 49, pg e46, 2018). Stroke; 2018;49(3):e46-e110. https:\/\/doi.org\/10.1161\/STR.0000000000000158.","DOI":"10.1161\/STR.0000000000000158"},{"key":"3422_CR2","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1212\/WNL.0b013e31822f0423","volume":"77","author":"CD Bushnell","year":"2011","unstructured":"Bushnell CD, Olson DM, Zhao X, Pan W, Zimmer LO, Goldstein LB, et al. Secondary preventive medication persistence and adherence 1 year after stroke. Neurology. 2011;77:1182\u201390.","journal-title":"Neurology"},{"key":"3422_CR3","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1111\/j.1365-2125.1993.tb05689.x","volume":"35","author":"PJ Roderick","year":"1993","unstructured":"Roderick PJ, Wilkes HC, Meade TW. The gastrointestinal toxicity of aspirin - an overview of randomized controlled trials. Br J Clin Pharmacol. 1993;35:219\u201326.","journal-title":"Br J Clin Pharmacol"},{"key":"3422_CR4","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1212\/01.WNL.0000118288.04483.02","volume":"62","author":"I Sibon","year":"2004","unstructured":"Sibon I, Orgogozo JM. Antiplatelet drug discontinuation is a risk factor for ischemic stroke. Neurology. 2004;62:1187\u20139.","journal-title":"Neurology"},{"key":"3422_CR5","doi-asserted-by":"crossref","unstructured":"Diener HC, Cunha L, Forbes C, Sivenius J, Smets P, Lowenthal A. European stroke prevention study .2. Dipyridamole and acetylsalicylic acid in the secondary prevention of stroke. J Neurological Sci. 1996;143:1\u201313","DOI":"10.1016\/S0022-510X(96)00308-5"},{"key":"3422_CR6","doi-asserted-by":"publisher","first-page":"861","DOI":"10.1016\/S0140-6736(19)31721-0","volume":"394","author":"ZI Attia","year":"2019","unstructured":"Attia ZI, Noseworthy PA, Lopez-Jimenez F, Asirvatham SJ, Deshmukh AJ, Gersh BJ, et al. An artificial intelligence-enabled ecg algorithm for the identification of patients with atrial fibrillation during sinus rhythm: a retrospective analysis of outcome prediction. Lancet. 2019;394:861\u20137.","journal-title":"Lancet"},{"key":"3422_CR7","doi-asserted-by":"publisher","unstructured":"Matz K, Seyfang L, Dachenhausen A, Teuschl Y, Tuomilehto J, Brainin M, et al. Post-stroke pneumonia at the stroke unit a registry based analysis of contributing and protective factors. BMC Neurol. 2016;16:107. https:\/\/doi.org\/10.1186\/s12883-016-0627-y.","DOI":"10.1186\/s12883-016-0627-y"},{"key":"3422_CR8","first-page":"3371","volume":"11","author":"P Vincent","year":"2010","unstructured":"Vincent P, Larochelle H, Lajoie I, Bengio Y, Manzagol PA. Stacked denoising autoencoders: Learning useful representations in a deep network with a local denoising criterion. J Mach Learn Res. 2010;11:3371\u2013408.","journal-title":"J Mach Learn Res"},{"key":"3422_CR9","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1002\/ejhf.1621","volume":"22","author":"MW Segar","year":"2020","unstructured":"Segar MW, Patel KV, Ayers C, Basit M, Tang WHW, Willett D, et al. Phenomapping of patients with heart failure with preserved ejection fraction using machine learning-based unsupervised cluster analysis. Eur J Heart Fail. 2020;22:148\u201358.","journal-title":"Eur J Heart Fail"},{"key":"3422_CR10","doi-asserted-by":"publisher","first-page":"2667","DOI":"10.1093\/eurheartj\/ehl334","volume":"27","author":"GGL Biondi-Zoccai","year":"2006","unstructured":"Biondi-Zoccai GGL, Lotrionte M, Agostoni P, Abbate A, Fusaro M, Burzotta F, et al. A systematic review and meta-analysis on the hazards of discontinuing or not adhering to aspirin among 50 279 patients at risk for coronary artery disease. Eur Heart J. 2006;27:2667\u201374.","journal-title":"Eur Heart J"},{"key":"3422_CR11","doi-asserted-by":"publisher","first-page":"472","DOI":"10.1161\/CIRCRESAHA.116.308398","volume":"120","author":"AK Boehme","year":"2017","unstructured":"Boehme AK, Esenwa C, Elkind MSV. Stroke risk factors, genetics, and prevention. Circ Res. 2017;120:472\u201395.","journal-title":"Circ Res"},{"key":"3422_CR12","doi-asserted-by":"publisher","first-page":"2559","DOI":"10.1161\/hs1101.098524","volume":"32","author":"AJ Grau","year":"2001","unstructured":"Grau AJ, Weimar C, Buggle F, Heinrich A, Goertler M, Neumaier S, et al. Risk factors, outcome, and treatment in subtypes of ischemic stroke - the german stroke data bank. Stroke. 2001;32:2559\u201366.","journal-title":"Stroke"},{"key":"3422_CR13","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1136\/bmj.324.7329.71","volume":"324","author":"C Baigent","year":"2002","unstructured":"Baigent C, Sudlow C, Collins R, Peto R, Antithromboci TC. Collaborative meta-analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ Br Med J. 2002;324:71\u201386.","journal-title":"BMJ Br Med J"},{"key":"3422_CR14","doi-asserted-by":"publisher","first-page":"2195","DOI":"10.1056\/NEJMoa0807646","volume":"359","author":"PM Ridker","year":"2008","unstructured":"Ridker PM, Danielson E, Fonseca FAH, Genest J, Gotto AM, Kastelein JJP, et al. Rosuvastatin to prevent vascular events in men and women with elevated c-reactive protein. N Engl J Med. 2008;359:2195\u2013207.","journal-title":"N Engl J Med"},{"key":"3422_CR15","doi-asserted-by":"publisher","first-page":"175628642092007","DOI":"10.1177\/1756286420920078","volume":"13","author":"CH Cui","year":"2020","unstructured":"Cui CH, Dong SJ, Chen N, et al. Low-dose statin pretreatment improves function and prognosis of recurrent ischemic stroke patients. Ther Adv Neurol Disord. 2020;13:1756286420920078. https:\/\/doi.org\/10.1177\/1756286420920078.","journal-title":"Ther Adv Neurol Disord."},{"key":"3422_CR16","doi-asserted-by":"publisher","unstructured":"Phan HT, Reeves MJ, Blizzard CL, et al. Sex Differences in Severity of Stroke in the INSTRUCT Study: a Meta-Analysis of Individual Participant Data. Journal of the American Heart Association 2019; 8. https:\/\/doi.org\/10.1177\/1756286420920078.","DOI":"10.1177\/1756286420920078"},{"key":"3422_CR17","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1161\/STROKEAHA.110.593434","volume":"42","author":"K Vemmos","year":"2011","unstructured":"Vemmos K, Ntaios G, Spengos K, Savvari P, Vemmou A, Pappa T, et al. Association between obesity and mortality after acute first-ever stroke the obesity-stroke paradox. Stroke. 2011;42:30\u20136.","journal-title":"Stroke"},{"key":"3422_CR18","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1186\/1471-2377-13-123","volume":"13","author":"CK Kim","year":"2013","unstructured":"Kim CK, Ryu WS, Kim BJ, Lee SH. Paradoxical effect of obesity on hemorrhagic transformation after acute ischemic stroke. BMC Neurology. 2013;13:123. https:\/\/doi.org\/10.1186\/1471-2377-13-123.","journal-title":"BMC Neurology."}],"container-title":["BMC Neurology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-023-03422-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12883-023-03422-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12883-023-03422-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T19:12:30Z","timestamp":1700248350000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcneurol.biomedcentral.com\/articles\/10.1186\/s12883-023-03422-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,13]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["3422"],"URL":"https:\/\/doi.org\/10.1186\/s12883-023-03422-0","relation":{},"ISSN":["1471-2377"],"issn-type":[{"value":"1471-2377","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,13]]},"assertion":[{"value":"8 December 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 October 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 October 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was performed in accordance with the Declaration of Helsinki and the ethical standards of the institutional and national research committees. The study was approved by the Ethics Committee of the Affiliated Liutie Central Hospital of Guangxi Medical University (KY-2017\u201302). Informed consent was obtained from all subjects and\/or their legal guardian(s).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"369"}}