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

Tak-Kyu Oh, In-Ae Song, Sol-Yi Lee and Hey-Ran Choi
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Tak-Kyu Oh: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
In-Ae Song: Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea
Sol-Yi Lee: Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul 04551, Korea
Hey-Ran Choi: Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul 04551, Korea

IJERPH, 2021, vol. 18, issue 16, 1-13

Abstract: 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. In total, 17,237 patients who underwent ECMO therapy were included; stroke occurred in 779 (4.5%) of 17,237 patients within 7 days of initiating the ECMO therapy. The number of patients in the anti-PLT and control groups was 3909 (22.7%) and 13,328 (77.3%), respectively. In the multivariable logistic regression analysis, the anti-PLT group showed 33% lower incidence of stroke than the control group (odds ratio (OR): 0.67, 95% confidence interval (CI): 0.55–0.82; p < 0.001). The cardiovascular group showed 35% lower incidence of stroke than the control group (OR: 0.65, 95% CI: 0.52–0.78; p < 0.001), whereas the respiratory group ( p = 0.821) and the other group ( p = 0.705) did not show any significant association. Prior anti-PLT therapy was associated with a lower incidence of stroke within 7 days of initiating ECMO therapy, which was more evident in the cardiovascular group.

Keywords: aspirin; clopidogrel; extracorporeal membrane oxygenation; intensive care units; stroke (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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