8,178 results match your criteria aspirin clopidogrel


Platelet reactivity and clinical outcomes following percutaneous coronary intervention in complex higher-risk patients.

J Cardiovasc Med (Hagerstown) 2021 Sep 20. Epub 2021 Sep 20.

Unit of Cardiovascular Science Unit of Internal Medicine, Department of Medicine, Campus Bio-Medico University, Rome, Italy.

Aims: To investigate the levels of platelet reactivity and the impact of high platelet reactivity (HPR) on long-term clinical outcomes of complex higher-risk and indicated patients (CHIP) with stable coronary artery disease (CAD) treated with elective percutaneous coronary intervention (PCI).

Methods: We enrolled 500 patients undergoing elective PCI for stable CAD and treated with aspirin and clopidogrel. Patients were divided into four groups based on the presence of CHIP features and HPR. Read More

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September 2021

Platelet Endothelial Aggregation Receptor 1 Polymorphism Is Associated With Functional Outcome in Small-Artery Occlusion Stroke Patients Treated With Aspirin.

Front Cardiovasc Med 2021 1;8:664012. Epub 2021 Sep 1.

Department of Neurology, Yangpu Hospital Tongji University School of Medicine, Shanghai, China.

The role of genetic polymorphisms is important in defining the patient's prognosis and outcomes in coronary artery disease. The present study aimed to explore the association between platelet endothelial aggregation receptor 1 (PEAR1) rs12041331 polymorphism and the outcomes in patients with acute ischemic stroke treated with aspirin or dual antiplatelet therapy (DAPT) with clopidogrel. A total of 868 ischemic stroke patients admitted to our hospital from January 1, 2016 to December 30, 2018 were retrospectively studied. Read More

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September 2021

Pattern and Outcome of Acute Non-ST-Segment Elevation Myocardial Infarction Seen in Adult Emergency Department of Al-Shaab Teaching Hospital: A prospective Observational Study in a Tertiary Cardiology Center.

Cureus 2021 Sep 14;13(9):e17981. Epub 2021 Sep 14.

Gastroenterology and Hepatology, University Hospitals of Morecambe Bay NHS Foundation Trust, Lancaster, GBR.

Background Despite investments to improve the quality of emergency care for patients with acute myocardial infarction (AMI), few studies have described national, real-world trends in non-ST elevation myocardial infarction (NSTEMI) care in the emergency department (ED). We aimed to describe the characteristics, management, and outcomes of NSTEMI. Methods A prospective single-center study enrolled 40 NSTEMI patients in Alshaab Teaching Hospital during the period from May to July 2021. Read More

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September 2021

Platelet Function Testing Is Required for Intracranial Stent Placement.

Authors:
René Chapot

Stroke 2021 Sep 20:STROKEAHA121036457. Epub 2021 Sep 20.

Department of Intracranial Endovascular Therapy, Alfried Krupp Hospital, Essen, Germany.

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September 2021

Efficacy and Safety of Ticagrelor Monotherapy by Clinical Presentation: Pre-Specified Analysis of the GLOBAL LEADERS Trial.

J Am Heart Assoc 2021 Sep 17;10(18):e015560. Epub 2021 Sep 17.

Department of Medicine and Institute of Health Policy, Management and Evaluation Applied Health Research CentreLi Ka Shing Knowledge Institute of St. Michael's HospitalUniversity of Toronto Canada.

Background The optimal duration of dual antiplatelet therapy after coronary drug-eluting stent placement in adults with stable coronary artery disease (SCAD) versus acute coronary syndromes (ACS) remains uncertain. Methods and Results This was a prespecified subgroup analysis of the GLOBAL LEADERS trial. Participants were randomly assigned 1:1 to the experimental or reference strategy, stratified by ACS (experimental, n=3750; reference, n=3737) versus SCAD (experimental, n=4230; reference, n=4251). Read More

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September 2021

Cilostazol for Secondary Stroke Prevention: History, Evidence, Limitations, and Possibilities.

Stroke 2021 Sep 14:STROKEAHA121035002. Epub 2021 Sep 14.

Department of Neurology, Stanford University (M.G.L.).

Cilostazol is a PDE3 (phosphodiesterase III) inhibitor with a long track record of safety that is Food and Drug Administration and European Medicines Agency approved for the treatment of claudication in patients with peripheral arterial disease. In addition, cilostazol has been approved for secondary stroke prevention in several Asian countries based on trials that have demonstrated a reduction in stroke recurrence among patients with noncardioembolic stroke. The onset of benefit appears after 60 to 90 days of treatment, which is consistent with cilostazol's pleiotropic effects on platelet aggregation, vascular remodeling, blood flow, and plasma lipids. Read More

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September 2021

Prevalence and associated factors of premature discontinuation of antiplatelet therapy after ischemic stroke: a nationwide population-based study.

BMC Neurol 2021 Sep 10;21(1):349. Epub 2021 Sep 10.

Department of Psychiatry, Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, 06236, Republic of Korea.

Background: We tried to evaluate the prevalence of premature discontinuation of antiplatelets and its affecting factors after ischemic stroke using large-sized representative national claims data.

Methods: Patients aged 20 years or older with newly confirmed ischemic stroke who started aspirin or clopidogrel for the first time were selected from 2003 to 2010 National Health Insurance Service-National Sample Cohort (NHIS-NSC) of South Korea (n = 4621), a randomly collected sample which accounts for 2.2% (n = 1,017,468) of total population (n = 46,605,433). Read More

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September 2021

Bedside testing of CYP2C19 vs. conventional clopidogrel treatment to guide antiplatelet therapy in ST-segment elevation myocardial infarction patients.

Int J Cardiol 2021 Sep 10. Epub 2021 Sep 10.

Department of Clinical Biochemistry, College of Medicine, Imam Abdulrahman bin Faisal University, Dammam, Saudi Arabia. Electronic address:

Background: ST-segment elevation myocardial infarction (STEMI) patients are treated with dual antiplatelet therapy comprising aspirin and a P2Y inhibitor. Clopidogrel is widely used in these patients in several areas worldwide, such as Middle East, but is associated to sub-optimal platelet inhibition in up to 1/3 of treated patients. We investigated a CYP2C19 genotype-guided strategy to select the optimal P2Y inhibitor. Read More

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September 2021

Treatment of In-Stent Stenosis Following Flow Diversion of Intracranial Aneurysms with Cilostazol and Clopidogrel.

Neurointervention 2021 Sep 10. Epub 2021 Sep 10.

Department of Neurosurgery, MedStar Georgetown University Hospital, Washington, DC, USA.

In-stent stenosis is a feared complication of flow diversion treatment for cerebral aneurysms. We present 2 cases of patients treated with pipeline flow diversion for unruptured cerebral aneurysms. Initial perioperative dual antiplatelet therapy (DAPT) consisted of standard aspirin plus clopidogrel. Read More

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September 2021

Differential Impact of Cytochrome 2C19 Allelic Variants on Three Different Platelet Function Tests in Clopidogrel-Treated Patients.

J Clin Med 2021 Sep 3;10(17). Epub 2021 Sep 3.

Laboratory for Clinical Thrombosis and Haemostasis, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, 6200 MD Maastricht, The Netherlands.

On-treatment platelet reactivity in clopidogrel-treated patients can be measured with several platelet function tests (PFTs). However, the agreement between different PFTs is only slight to moderate. Polymorphisms of the gene have an impact on the metabolization of clopidogrel and, thereby, have an impact on on-treatment platelet reactivity. Read More

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September 2021

Systemic antiplatelet agents and anticoagulants in eyes with branch retinal vein occlusion.

Ther Adv Ophthalmol 2021 Jan-Dec;13:25158414211040894. Epub 2021 Sep 2.

Duke Eye Center, Duke University, Durham, NC, USA.

Purpose: The purpose of this study was to investigate the effect of systemic antiplatelet agents and anticoagulants on the structural and functional outcomes of eyes with branch retinal vein occlusion (BRVO).

Methods: A retrospective longitudinal cohort study was performed on BRVO patients evaluated at a single tertiary care referral center between 2009 and 2017. Medical records were reviewed for antiplatelet agent and anticoagulant use including aspirin, clopidogrel, warfarin, rivaroxaban, apixaban, or dabigatran prior to BRVO onset. Read More

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September 2021

Safety and efficacy of a platelet glycoprotein Ib inhibitor for patients with non-ST segment elevation myocardial infarction: A phase Ib/IIa study.

Pharmacotherapy 2021 Sep 3. Epub 2021 Sep 3.

Department of Cardiology, Peking University First Hospital, Beijing, China.

Study Objective: This study aimed to determine the safety and efficacy of a novel GP Ib receptor inhibitor in patients with non-ST segment elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI).

Design And Setting: Multicenter, randomized, double-blind, placebo-controlled, dose-escalating, phase Ib-IIa clinical trial. Eligible patients were randomly assigned to the low-dose (n=20, 2 IU/60 kg), moderate-dose (n=20, 3 IU/60 kg), or high-dose anfibatide group (n=20, 5 IU/60 kg), or the placebo group (n=30). Read More

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September 2021

Prevalence of CYP2C19 and ITGB3 polymorphisms among Bangladeshi patients who underwent percutaneous coronary intervention.

SAGE Open Med 2021 26;9:20503121211042209. Epub 2021 Aug 26.

Department of Pharmacy, University of Asia Pacific, Dhaka, Bangladesh.

Introduction: Antithrombotic agents are the basic therapeutic option for patients with arterial thrombosis who underwent percutaneous coronary intervention (PCI). In Bangladesh, aspirin and clopidogrel are frequently prescribed as antithrombotics or platelet inhibitors. Studies reported the genetic polymorphisms of CYP2C19*2, CYP2C19*17, and ITGB3 cause an alteration of the pharmacodynamic and pharmacokinetic profile of aspirin and clopidogrel. Read More

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Antithrombotic therapy in high-risk patients after percutaneous coronary intervention; study design, cohort profile and incidence of adverse events.

Neth Heart J 2021 Oct 1;29(10):525-535. Epub 2021 Sep 1.

Thrombosis Expertise Centre, Heart and Vascular Centre, Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.

Background: Patients with multiple clinical risk factors are a complex group in whom both bleeding and recurrent ischaemic events often occur during treatment with dual/triple antithrombotic therapy after percutaneous coronary intervention. Decisions on optimal antithrombotic treatment in these patients are challenging and not supported by clear guideline recommendations. A prospective observational cohort study was set up to evaluate patient-related factors, platelet reactivity, genetics, and a broad spectrum of biomarkers in predicting adverse events in these high-risk patients. Read More

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October 2021

[Anti-Platelet and Anti-Coagulant Drugs].

Authors:
Kazuo Kitagawa

Brain Nerve 2021 Sep;73(9):975-982

Department of Neurology, Tokyo Women's Medical University.

Antithrombotic therapy is essential for secondary stroke prevention. Clinical practice guidelines recommend anticoagulant and antiplatelet drug administration as first-line therapy for cardioembolic stroke and non-cardioembolic infarction, respectively. Direct oral anticoagulants represent first-choice treatment for cardioembolism secondary to non-valvular atrial fibrillation owing to few hemorrhagic complications associated with this therapy. Read More

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September 2021

Guided and unguided de-escalation from potent P2Y12 inhibitors among patients with ACS: a meta-analysis.

Eur Heart J Cardiovasc Pharmacother 2021 Aug 30. Epub 2021 Aug 30.

The Zena and Michael A. Weiner Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Aim: Optimal dual antiplatelet therapy (DAPT) in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) intends to balance ischemic and bleeding risks. Various DAPT de-escalation strategies, defined as switching from a full-dose potent to a reduced dose or less potent P2Y12 inhibitor, have been evaluated in several ACS-PCI trials. We aimed to compare DAPT de-escalation to standard DAPT with full dose potent P2Y12 inhibitors in ACS patients who underwent PCI. Read More

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Association of prehospital antiplatelet therapy with survival in patients hospitalized with COVID-19: A propensity score-matched analysis.

J Thromb Haemost 2021 Aug 29. Epub 2021 Aug 29.

George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Purpose: Coronavirus disease 2019 (COVID-19) is associated with hypercoagulability and increased thrombotic risk. The impact of prehospital antiplatelet therapy on in-hospital mortality is uncertain.

Methods: This was an observational cohort study of 34 675 patients ≥50 years old from 90 health systems in the United States. Read More

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Network Meta-analysis of the Benefit of Aspirin with Rivaroxaban vs. Clopidogrel for Patients with Stable Symptomatic Lower Extremity Arterial Disease.

Eur J Vasc Endovasc Surg 2021 Aug 24. Epub 2021 Aug 24.

Bristol Centre for Surgical Research, Bristol Medical School, University of Bristol, UK. Electronic address:

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Why Me? To Be an Ultra-Responder to Antiplatelet Therapy: A Case Report.

Front Neurol 2021 10;12:663308. Epub 2021 Aug 10.

Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Stroke Center, Maggiore Hospital, Bologna, Italy.

Platelet function testing is a valid tool to investigate the clinical response to antiplatelet therapy in different clinical settings; in particular, it might supply helpful information in patients with cerebrovascular disease. Oral antiplatelet treatment, such as Aspirin (ASA) and Clopidogrel, is the gold standard in secondary stroke prevention of non-cardiogenic ischemic stroke; conversely, its application as a primary prevention therapy is not routinely recommended in patients with vascular risk factors. Multiple electrode platelet aggregometry (MEA) impedance aggregometer is a validated device to test platelet inhibition induced by ASA or Clopidogrel. Read More

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Clopidogrel Resistance in Patients With Stroke Recurrence Under Single or Dual Antiplatelet Treatment.

Front Neurol 2021 10;12:652416. Epub 2021 Aug 10.

Department of Neurology, Asan Medical Center, University of Ulsan, School of Medicine, Seoul, South Korea.

The factors associated with clopidogrel resistance in patients with stroke recurrence receiving single or dual antiplatelet treatment (SAPT or DAPT) may differ. This study compared the high on-treatment platelet reactivities (HPRs) and the factors associated with clopidogrel resistance in recurrent ischemic stroke patients receiving clopidogrel or aspirin and clopidogrel. We enrolled and allocated 275 recurrent ischemic stroke patients to the clopidogrel and DAPT groups and compared their demographics, conventional risk factors, and P2Y12 reaction units (PRUs). Read More

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Evaluating the Need of Continuing the Antiplatelet Drug Therapy in Patients Undergoing Minor Oral Surgical Procedures.

J Pharm Bioallied Sci 2021 Jun 5;13(Suppl 1):S80-S83. Epub 2021 Jun 5.

Oral and Maxillofacial Surgeon, Jyoti Kendra General Hospital, Ludhiana, Punjab, India.

Background: Dental treatment in patients on antiplatelet drug therapy is a long standing debate. Discontinuation of medication increases the risk of thrombotic complications, whereas continuation leads to increased postoperative bleeding.

Aim: We conducted this prospective cross-sectional study to assess risk of bleeding in patients continuing antiplatelet medication while performing minor oral surgical procedures such as single or multiple teeth extraction, transalveolar extraction of third molar, biopsy, and alveoloplasty. Read More

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Platelet dysfunction in patients with traumatic intracranial hemorrhage: Do desmopressin and platelet therapy help or harm?

Am J Surg 2021 Aug 3. Epub 2021 Aug 3.

Department of Surgery, Division of Trauma and Surgical Critical Care, Rutgers New Jersey Medical School, 185 S Orange Ave, Newark, New Jersey, 07101, USA. Electronic address:

Background: Pre-injury anti-platelet use has been associated with increased risk of progression of traumatic intracranial hemorrhage (TICH) and worse outcomes. VerifyNow® assays assess platelet inhibition due to aspirin/clopidogrel. This study assesses the outcomes of patients with TICH and platelet dysfunction treated with desmopressin and/or platelets. Read More

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Prior Antiplatelet Therapy and Stroke Risk in Critically Ill Patients Undergoing Extracorporeal Membrane Oxygenation.

Int J Environ Res Public Health 2021 08 17;18(16). Epub 2021 Aug 17.

Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul 04551, Korea.

We aimed to investigate whether prior exposure to antiplatelet therapy (anti-PLT) was associated with stroke incidence after the initiation of extracorporeal membrane oxygenation (ECMO) therapy. We conducted a population-based cohort study based on health records obtained from the National Health Insurance Service database in South Korea. Adult patients (aged ≥ 18 years) who underwent ECMO therapy in the intensive care unit during 2009-2018 were enrolled. Read More

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Expression of NLR and IL-1β and their predictive efficacy value in acute myocardial infarction patients treated with aspirin combined with clopidogrel.

J Biol Regul Homeost Agents 2021 08 26;35(4). Epub 2021 Aug 26.

Department of Emergency, the Third People's Hospital of Qingdao, Qingdao, China.

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Effectiveness and safety of dual antiplatelet therapy in coronary aneurysms caused by Kawasaki disease in children: study protocol for a multicenter randomized clinical trial.

Transl Pediatr 2021 Jul;10(7):1914-1923

Clinical Research Institute of Peking University, Beijing, China.

Background: Medium or large coronary artery aneurysm (CAA) is a serious complication of Kawasaki disease (KD) and may cause thrombosis, coronary artery stenosis, and even myocardial infarction at different stages of the disease. Dual antiplatelet therapy (aspirin plus clopidogrel) is considered for prophylaxis of coronary thrombosis in KD presenting with more than medium CAAs based on adult coronary artery disease experience and expert consensus. This paper describes the study protocol for a randomized controlled trial that measures the clinical effectiveness and safety of dual antiplatelet therapy in the thromboprophylactic treatment of KD. Read More

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P2Y12 receptor inhibitor plus aspirin versus aspirin treated within 24 hours of acute noncardioembolic ischemic stroke or TIA: Meta-analysis.

J Formos Med Assoc 2021 Aug 20. Epub 2021 Aug 20.

Department of Neurology, Chang Gung University College of Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan. Electronic address:

Background/purpose: Antiplatelet therapy is the cornerstone for acute ischemic stroke or transient ischemic attack (TIA). The purpose of this study was to conduct a meta-analysis to assess the efficacy and safety of P2Y12 receptor inhibitor plus aspirin versus aspirin alone treated within 24 h after acute noncardioembolic ischemic stroke or TIA.

Methods: We search Pubmed, EMBASE, CENTRAL and clinicaltrials. Read More

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European Stroke Organisation expedited recommendation for the use of short-term dual antiplatelet therapy early after minor stroke and high-risk TIA.

Eur Stroke J 2021 Jun 18;6(2):VI. Epub 2021 Jun 18.

Department of Neurosciences (Neurology), Hospital de Santa Maria, University of Lisbon, Lisboa, Portugal.

Prevention of early recurrent ischaemic stroke remains a priority in people with TIA or ischaemic stroke. A number of trials have recently been completed assessing the efficacy of short-term dual antiplatelet therapy (DAPT) versus single antiplatelet therapy early after minor or moderate stroke or high-risk TIA. We present an Expedited Recommendation for use of dual antiplatelet therapy early after ischaemic stroke and TIA on behalf of the ESO Guideline Board. Read More

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European Stroke Organisation (ESO) guidelines on management of transient ischaemic attack.

Eur Stroke J 2021 Jun 18;6(2). Epub 2021 Jun 18.

Hospital Universitari Arnau de Vilanova, Institut de Recerca Biomedica de Lleida (IRBLleida), Universitat de Lleida (UdL), Lleida, Spain.

The aim of the present European Stroke Organisation Transient Ischaemic Attack (TIA) management guideline document is to provide clinically useful evidence-based recommendations on approaches to triage, investigation and secondary prevention, particularly in the acute phase following TIA. The guidelines were prepared following the Standard Operational Procedure for a European Stroke Organisation guideline document and according to GRADE methodology. As a basic principle, we defined TIA clinically and pragmatically for generalisability as transient neurological symptoms, likely to be due to focal cerebral or ocular ischaemia, which last less than 24 hours. Read More

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European Stroke Organisation expedited recommendation for the use of short-term dual antiplatelet therapy early after minor stroke and high-risk TIA.

Eur Stroke J 2021 Jun 11;6(2):CLXXXVII-CXCI. Epub 2021 Mar 11.

Department of Neurosciences (Neurology), Hospital de Santa Maria, University of Lisbon, Lisboa, Portugal.

Prevention of early recurrent ischaemic stroke remains a priority in people with TIA or ischaemic stroke. A number of trials have recently been completed assessing the efficacy of short-term dual antiplatelet therapy (DAPT) versus single antiplatelet therapy early after minor or moderate stroke or high-risk TIA. We present an Expedited Recommendation for use of dual antiplatelet therapy early after ischaemic stroke and TIA on behalf of the ESO Guideline Board. Read More

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European Stroke Organisation (ESO) guidelines on management of transient ischaemic attack.

Eur Stroke J 2021 Jun 16;6(2):CLXIII-CLXXXVI. Epub 2021 Mar 16.

Hospital Universitari Arnau de Vilanova, Institut de Recerca Biomedica de Lleida (IRBLleida), Universitat de Lleida (UdL), Lleida, Spain.

The aim of the present European Stroke Organisation Transient Ischaemic Attack (TIA) management guideline document is to provide clinically useful evidence-based recommendations on approaches to triage, investigation and secondary prevention, particularly in the acute phase following TIA. The guidelines were prepared following the Standard Operational Procedure for a European Stroke Organisation guideline document and according to GRADE methodology. As a basic principle, we defined TIA clinically and pragmatically for generalisability as transient neurological symptoms, likely to be due to focal cerebral or ocular ischaemia, which last less than 24 hours. Read More

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