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  • Prehospital antiplatelet use and functional status on admission of patients with non-haemorrhagic moyamoya disease: a nationwide retrospective cohort study (J-ASPECT study)

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Epidemiology
Research
Prehospital antiplatelet use and functional status on admission of patients with non-haemorrhagic moyamoya disease: a nationwide retrospective cohort study (J-ASPECT study)
  1. Daisuke Onozuka1,
  2. Akihito Hagihara1,
  3. Kunihiro Nishimura2,
  4. Akiko Kada3,
  5. Jyoji Nakagawara4,
  6. Kuniaki Ogasawara5,
  7. Junichi Ono6,
  8. Yoshiaki Shiokawa7,
  9. Toru Aruga8,
  10. Shigeru Miyachi9,
  11. Izumi Nagata10,
  12. Kazunori Toyoda11,
  13. Shinya Matsuda12,
  14. Akifumi Suzuki13,
  15. Hiroharu Kataoka14,
  16. Fumiaki Nakamura15,
  17. Satoru Kamitani15,
  18. Ataru Nishimura16,
  19. Ryota Kurogi16,
  20. Tetsuro Sayama16,
  21. Koji Iihara16,
  22. the J-ASPECT Study Collaborators
  1. 1Department of Health Communication, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  2. 2Department of Preventive Medicine and Epidemiologic Informatics, National Cerebral and Cardiovascular Center, Osaka, Japan
  3. 3Clinical Research Center, Nagoya Medical Center, Aichi, Japan
  4. 4Department of Integrative Stroke Imaging Center, National Cerebral and Cardiovascular Center, Osaka, Japan
  5. 5Department of Neurosurgery, Iwate Medical University, Iwate, Japan
  6. 6Chiba Cardiovascular Center, Chiba, Japan
  7. 7Department of Neurosurgery, Kyorin University, Tokyo, Japan
  8. 8Showa University Hospital, Tokyo, Japan
  9. 9Department of Neurosurgery, Osaka Medical College, Osaka, Japan
  10. 10Kokura Memorial Hospital, Fukuoka, Japan
  11. 11Department of Cerebrovascular Medicine and Neurology, National Cerebral and Cardiovascular Center, Osaka, Japan
  12. 12Department of Preventive Medicine and Community Health, School of Medicine, University of Occupational and Environmental Health, Fukuoka, Japan
  13. 13Akita Prefectural Hospital Organization Research Institute for Brain and Blood Vessels, Akita, Japan
  14. 14Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Japan
  15. 15Department of Public Health/Health Policy, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
  16. 16Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
  1. Correspondence to Professor Koji Iihara; kiihara{at}ns.med.kyushu-u.ac.jp

Abstract

Objectives To elucidate the association between antiplatelet use in patients with non-haemorrhagic moyamoya disease before hospital admission and good functional status on admission in Japan.

Design Retrospective, multicentre, non-randomised, observational study.

Setting Nationwide registry data in Japan.

Participants A total of 1925 patients with non-haemorrhagic moyamoya disease admitted between 1 April 2012 and 31 March 2014 in Japan.

Main outcome measure We performed propensity score-matched analysis to examine the association between prehospital antiplatelet use and no significant disability on hospital admission, as defined by a modified Rankin Scale score of 0 or 1.

Results Propensity-matched patients who received prehospital antiplatelet drugs were associated with a good outcome on hospital admission (OR adjusted for all covariates, 3.82; 95% CI 1.22 to 11.99) compared with those who did not receive antiplatelet drugs prior to hospital admission.

Conclusions Prehospital antiplatelet use was significantly associated with good functional status on hospital admission among patients with non-haemorrhagic moyamoya disease in Japan. Our results suggest that prehospital antiplatelet use should be considered when evaluating outcomes of patients with non-haemorrhagic moyamoya disease.

  • EPIDEMIOLOGY
  • STROKE MEDICINE
  • STATISTICS & RESEARCH METHODS

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2015-009942

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