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  • 1
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    Development and Validation of the Modified Charlson Comorbidity Index in Incident Peritoneal Dialysis Patients: A National Population-Based Approach
    SAGE Publications ; 2017
    In:  Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis Vol. 37, No. 1 ( 2017-01), p. 94-102
    Details
    In: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, SAGE Publications, Vol. 37, No. 1 ( 2017-01), p. 94-102
    Abstract: The utility of applying the Charlson comorbidity index (CCI) to peritoneal dialysis (PD) patients is disputed because the relative weight of each comorbidity in PD patients may be different from those in other chronic diseases. We aimed to develop and validate a modified CCI in incident PD patients (mCCI-IPD) for better risk stratification and prediction of mortality. Methods The mCCI-IPD was developed using data from all Korean adult incident PD patients between 2005 and 2008 ( n = 7,606). Multivariate Cox regression was used to determine new weights for the individual comorbidities in the CCI. The prognostic performance of the mCCI-IPD was validated in an independent cohort ( n = 664) through c-statistics and continuous net reclassification improvement (cNRI). Results A total of 75.5% of the patients in the development cohort had 1 or more comorbidities. The Cox proportional hazards model provided reassigned severity weights for the 11 comorbidities that significantly predicted mortality. In the validation cohort, the CCI and mCCI-IPD scores were both correlated with survival and showed no differences in their c-statistics. However, multivariate analyses using cNRI revealed that the mCCI-IPD provided a 38.2% improvement in mortality risk assessment compared with the CCI (95% confidence interval [CI], 15.3 – 61.0; p 〈 0.001). These significant reclassification improvements were observed consistently in subjects with events (cNRI Event , 28.2% [95% CI, 6.9 – 49.5; p = 0.009]) and without events (cNRI Non-event , 10.0% [95% CI, 1.7 – 18.2; p = 0.019]). Conclusions Compared with the CCI, the mCCI-IPD showed better performance in mortality prediction for incident PD patients. Therefore, this tool may be used as a preferred index for statistical analysis and clinical decision-making.
    Type of Medium: Online Resource
    ISSN: 0896-8608 , 1718-4304
    URL: Article
    DOI: 10.3747/pdi.2015.00201
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
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  • 2
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    The Clinical Usefulness of Peritoneal Dialysis Fluids with Neutral pH and Low Glucose Degradation Product Concentration: An Open Randomized Prospective Trial
    SAGE Publications ; 2008
    In:  Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis Vol. 28, No. 2 ( 2008-03), p. 174-182
    Details
    In: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, SAGE Publications, Vol. 28, No. 2 ( 2008-03), p. 174-182
    Abstract: Long-term peritoneal dialysis (PD) is associated with the development of various structural and functional changes to the peritoneal membrane when bioincompatible conventional peritoneal dialysis fluids (PDFs) are used. In this study, we looked at patients that were treated with conventional PDFs and then changed to novel biocompatible PDFs with a neutral pH and a low concentration of glucose degradation products (GDPs) to investigate whether this change could result in the arrest or reversal of peritoneal membrane deterioration. Methods In an open label, randomized prospective trial, the clinical effects of conventional PDFs and biocompatible PDFs with neutral pH and very low concentration of GDPs were compared in 104 patients equally divided between both study PDFs. Blood and effluent dialysate samples, peritoneal equilibration tests, and adequacy evaluation were undertaken at baseline, 4, 8, and 12 months. The target variables were the ratio of dialysate-to-plasma (D/P) creatinine, peritoneal ultrafiltration, residual renal function, dialysis adequacy indices, and effluent cancer antigen 125 (CA125). Results D/P creatinine values were not different in the two groups. Peritoneal ultrafiltration was significantly higher in the low-GDP PDF group than in the conventional PDF group at all follow-up times (4 months: 9.1 ± 4.3 vs 6.0 ± 3.0; 8 months: 8.3 ± 3.4 vs 6.0 ± 3.0; 12 months: 8.9 ± 3.3 vs 6.1 ± 3.3 mL/g dextrose/day; p 〈 0.05). Peritoneal Kt/V urea values and total weekly Kt/V urea values at 4 months were significantly higher in the low-GDP PDF group than in the conventional PDF group. Residual renal function was not statistically significant. Effluent CA125 levels were significantly higher in the low-GDP PDF group at all follow-up visits (4 months: 37.8 ± 20.8 vs 22.0 ± 9.5; 8 months: 41.2 ± 20.3 vs 25.9 ± 11.3; 12 months: 40.4 ± 21.4 vs 28.6 ± 13.0 U/mL; p 〈 0.05). Among anuric patients, peritoneal ultrafiltration at 4, 8, and 12 months, total weekly Kt/V at 4 and 8 months, and CA125 levels at all follow-up visits were significantly higher in patients treated with low-GDP PDF than those treated with conventional PDF. However, among anuric patients, D/P creatinine showed no significant differences between the low-GDP PDF group and the conventional PDF group. Conclusion The use of biocompatible PDFs with neutral pH and low GDP concentration can contribute to improvement of peritoneal ultrafiltration and peritoneal effluent CA125 level, an indicator of peritoneal membrane integrity in PD patients.
    Type of Medium: Online Resource
    ISSN: 0896-8608 , 1718-4304
    URL: Article
    DOI: 10.1177/089686080802800214
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
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  • 3
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    Changes in Causative Organisms and Their Antimicrobial Susceptibilities in Capd Peritonitis: A Single Center's Experience over one Decade
    SAGE Publications ; 2004
    In:  Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis Vol. 24, No. 5 ( 2004-09), p. 424-432
    Details
    In: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, SAGE Publications, Vol. 24, No. 5 ( 2004-09), p. 424-432
    Abstract: In recent years, the rate of peritonitis during continuous ambulatory peritoneal dialysis (CAPD) has been significantly reduced. However, peritonitis remains a major complication of CAPD, accounting for considerable mortality and hospitalization among CAPD patients. Objective To generate a “center tailored” treatment protocol for CAPD peritonitis by examining the changes of causative organisms and their susceptibilities to antimicrobial agents over the past 10 years. Method Retrospective review of the medical records of 1015 CAPD patients (1108 episodes of peritonitis) who were followed up from 1992 through 2001. Results The overall incidence of peritonitis was 0.40 episodes/patient-year. The annual rate of peritonitis and the incidence of peritonitis caused by a single gram-positive organism were significantly higher in 1992 and 1993 compared with those in the rest of the years ( p 〈 0.05). The incidence of peritonitis due to coagulase-negative staphylococcus (CoNS) decreased significantly over time, whereas there was no significant change in the incidence of Staphylococcus aureus (SA)-induced peritonitis. Among CoNS, resistance to methicillin increased from 18.4% in 1992 – 1993 to 41.7% in 2000 – 2001 ( p 〈 0.05). In contrast, the incidence of methicillin-resistant SA was not different according to the calendar year. Catheter removal rates were significantly higher in peritonitis due to a single gram-negative organism (16.6%) compared with gram-positive peritonitis (4.8%, p 〈 0.005). The mortality associated with peritonitis was also higher in gram-negative (3.7%) compared with gram-positive peritonitis (1.4%), but there was no statistical significance. Among single gram-positive organism-induced peritonitis, catheter removal rates were significantly higher in SA (9.3%) than those in CoNS (2.9%, p 〈 0.01) and other gram-positive organisms (2.9%, p 〈 0.05). In peritonitis caused by CoNS, the methicillin-resistant group showed significantly higher removal rates than the methicillin-susceptible group (8.2% vs 1.0%, p 〈 0.01). Conclusion The incidence of peritonitis for 2001 decreased to less than half that for 1992, due mainly to a significant decrease in CoNS-induced peritonitis, whereas the proportions of peritonitis due to a single gram-negative organism and methicillin-resistant CoNS increased. These findings suggest that it is necessary to prepare new center-based guidelines for the initial empirical treatment of CAPD peritonitis.
    Type of Medium: Online Resource
    ISSN: 0896-8608 , 1718-4304
    URL: Article
    DOI: 10.1177/089686080402400506
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2004
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  • 4
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    Salvage therapy using self-expandable metal stents for recalcitrant anastomotic strictures after living-donor liver transplantation
    SAGE Publications ; 2017
    In:  Therapeutic Advances in Gastroenterology Vol. 10, No. 3 ( 2017-03), p. 297-309
    Details
    In: Therapeutic Advances in Gastroenterology, SAGE Publications, Vol. 10, No. 3 ( 2017-03), p. 297-309
    Abstract: Recently, there has been an increase in clinical success rates using nonsurgical methods to resolve anastomotic biliary strictures (ABSs) that develop after liver transplantation (LT). However, some strictures are particularly refractory and cannot be completely resolved by an endoscopic or percutaneous procedure. Consequently, the aim of this study was to examine the feasibility and efficacy of using a newly designed fully covered self-expandable metal stent (FCSEMS) to resolve refractory ABS. Methods: A total of 35 patients with an ABS that developed after LT, but could not be resolved by an endoscopic or percutaneous procedure, were included in this study. FCSEMSs were positioned endoscopically and removed after 2–3 months. After stent removal, the patients were followed to assess complications, including re-stenosis. Results: The mean period from LT to stricture was 13.7 months, and the mean duration of the stricture was 31.8 months. The type and mean number of procedures previously attempted were endoscopic retrograde cholangiopancreatography (ERCP) (9.1 ± 5.1) in 19 patients and percutaneous transhepatic biliary drainage (9.2 ± 4.8) in 16 patients. All patients had successful FCSEMS insertions and removals; the mean stent indwelling time was 3.2 months. The mean follow-up period was 18.7 months (range: 6.4–37.8 months). Stricture recurrence was observed in 6 of 29 patients (recurrence rate: 20.7%). The anastomotic stricture resolved with the FCSEMS insertion in 29 of 35 patients (clinical success rate: 82.9%). Conclusions: The newly designed FCSEMS is a potentially feasible and effective treatment for anastomotic strictures that develop after LT but are not amenable to treatment by conventional procedures.
    Type of Medium: Online Resource
    ISSN: 1756-2848 , 1756-2848
    URL: Article
    DOI: 10.1177/1756283X16685059
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2017
    detail.hit.zdb_id: 2440710-0
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  • 5
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    Nonvascular drug-eluting stent coated with sodium caprate-incorporated polyurethane for the efficient penetration of paclitaxel into tumor tissue
    SAGE Publications ; 2015
    In:  Journal of Biomaterials Applications Vol. 29, No. 8 ( 2015-03), p. 1133-1144
    Details
    In: Journal of Biomaterials Applications, SAGE Publications, Vol. 29, No. 8 ( 2015-03), p. 1133-1144
    Abstract: To increase the therapeutic potency of nonvascular drug-eluting stents, sodium caprate was employed as a drug-penetration enhancer. A polytetrafluoroethylene-covered drug-eluting stent was coated with a mixture containing sodium caprate, paclitaxel, and polyurethane via the rolling coating technique. The coated stent has a smooth membrane surface with a 40-µm membrane thickness. Paclitaxel was released from the coated stent for two months. In the multilayered cell sheet model, sodium caprate in the polyurethane membrane (PUSC10) showed the possibility of enhancing the paclitaxel tissue penetration. The amount of penetrated paclitaxel for the sodium caprate-containing polyurethane membrane (PUSC10) was two times higher than that of sodium caprate-free polyurethane membrane. Additionally, the potential of sodium caprate was confirmed by a tumor-bearing small animal model. PUSC10 incorporated with Nile red (as a model fluorescence dye for visualization of drug penetration; PUSC10–Nile red) or PUSC10 incorporated with paclitaxel (PUSC10–paclitaxel) membrane was implanted at tumor sites in Balb/c mice. In the case of PUSC10–Nile red, the tissue penetration depth of Nile red was significantly increased from 30 µm (without sodium caprate) to 1060 µm (with sodium caprate). After seven days, an almost four times higher therapeutic area of PUSC10–paclitaxel was observed compared to that of polyurethane–paclitaxel (without sodium caprate) by a terminal deoxynucleotidyl transferase dUTP nick end labeling assay. The results indicate that sodium caprate improves the penetration and therapeutic efficiencies of drugs in drug-eluting stents, and thus, it has potential for local stent therapy.
    Type of Medium: Online Resource
    ISSN: 0885-3282 , 1530-8022
    URL: Article
    DOI: 10.1177/0885328214552712
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2015
    detail.hit.zdb_id: 2072559-0
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  • 6
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    Effect of Liver Cirrhosis on the Outcomes of Peritoneal Dialysis
    SAGE Publications ; 2019
    In:  Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis Vol. 39, No. 6 ( 2019-11), p. 502-508
    Details
    In: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, SAGE Publications, Vol. 39, No. 6 ( 2019-11), p. 502-508
    Abstract: Peritoneal dialysis (PD) has become an increasingly important treatment modality for end-stage renal disease. However, application of PD in patients with liver cirrhosis (LC) and subsequent outcomes have not been thoroughly evaluated. Methods A total of 1,366 patients (≥ 18 years old) who started PD at 4 tertiary referral centers between January 2000 and December 2015 were initially reviewed. Among them, 45 patients with LC were finally analyzed (LC-PD). Using the multivariate Cox hazard ratio (HR) model, outcomes such as technique failure, infection, and mortality in patients with LC-PD were compared with those in non-LC-PD patients (non-LC-PD) or patients with LC who received hemodialysis (LC-HD). All of the patients were selected by 1:1 matching of age, sex, catheter insertion date, and diabetes mellitus. Results During the mean follow-up duration of 43 ± 35.8 months, 12 patients with LC-PD experienced technique failure, and this rate was similar to that of non-LC-PD patients. In evaluating infection episodes, the most common causes for peritonitis and exit-site infection were Escherichia coli (5.8%) and Staphylococcus aureus (19.3%), respectively; these event rates of LC-PD did not differ from those of non-LC-PD. The all-cause mortality rate of the LC-PD group was not different from that of the non-LC-PD and LC-HD groups. Conclusion Dialysis outcomes such as technique failure, infection, and mortality are not affected by the presence of LC. Accordingly, PD therapy is a good option in patients with LC.
    Type of Medium: Online Resource
    ISSN: 0896-8608 , 1718-4304
    URL: Article
    DOI: 10.3747/pdi.2018.00247
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2019
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  • 7
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    Long-Term Clinical Outcomes of Peritoneal Dialysis Patients: Single Center Experience from Korea
    SAGE Publications ; 2008
    In:  Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis Vol. 28, No. 3_suppl ( 2008-06), p. 21-26
    Details
    In: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, SAGE Publications, Vol. 28, No. 3_suppl ( 2008-06), p. 21-26
    Abstract: Of a large body of literature reporting clinical outcomes for patients maintained on peritoneal dialysis (PD), most publications have focused on relatively short-term results. Few reports have focused on long-term survival in PD patients. Here, we present our experience with long-term patient outcomes and further analyses of the trends in demographics and clinical outcomes of 2301 end-stage renal disease (ESRD) patients treated with continuous ambulatory PD (CAPD) during a 25-year period (1981 – 2005) at our institute. Outcomes were analyzed for 1656 patients, excluding those younger than 15 years of age at initiation of CAPD, those having less than 3 months’ follow-up, or those who had been on hemodialysis or who received a kidney graft before starting CAPD. In the study patients, technique survival at 5 and 10 years was 71.9% and 48.1% respectively. Patient survival was 69.8% and 51.8%. Mean age at the start of PD (50.4 ± 13.9 years vs. 44.2 ± 13.9 years, p 〈 0.01), ESRD incidence as a result of diabetic nephropathy (30.5% vs. 19.5%, p 〈 0.01), and incidence of cardiovascular comorbidities (26.6% vs. 20.5%, p 〈 0.01) were all significantly greater in patients who started PD during the second half of the study period (1993 – 2005) as compared with the first half (1981 – 1992). A multivariate analysis adjusting for these changes in demographics and comorbid conditions revealed that PD therapy starting in 1993 – 2005 was associated with a significant reduction in technique failure [hazard ratio (HR): 0.65; p 〈 0.01] and mortality (HR: 0.68; p 〈 0.01) as compared with the earlier period. However, in subgroup analyses, technique survival was not observed to be significantly improved in patients with diabetes. In summary, technique and patient survival have significantly improved despite increases in patient age, cardiovascular comorbidity, and ESRD caused by diabetes. Although diabetes, older age, and cardiovascular comorbidities are not factors that are easily modifiable to improve PD outcomes, results at our institution are encouraging in an era of declining PD utilization.
    Type of Medium: Online Resource
    ISSN: 0896-8608 , 1718-4304
    URL: Article
    DOI: 10.1177/089686080802803s05
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
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  • 8
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    Risk Factors for Adverse Outcomes after Peritonitis-Related Technique Failure
    SAGE Publications ; 2008
    In:  Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis Vol. 28, No. 4 ( 2008-07), p. 352-360
    Details
    In: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, SAGE Publications, Vol. 28, No. 4 ( 2008-07), p. 352-360
    Abstract: Peritonitis is the leading cause of technique failure in peritoneal dialysis (PD) patients. Some patients experience recurrent ascites, encapsulating peritoneal sclerosis (EPS), and even death after catheter removal. Little is known, however, about the risk factors for such complications. Methods The study subjects were 117 patients that had their PD catheter removed due to peritonitis between January 2000 and June 2006. Biochemical and clinical data were reviewed retrospectively. Serum C-reactive protein (CRP) and blood and effluent white blood cell counts (WBC) were measured at baseline and at 72 hours of peritonitis. Based on adverse outcomes, patients were classified into 4 groups: non-complication (NC; n = 73), recurrent ascites (A; n = 26), EPS (E; n = 10), and death directly related to peritonitis (D; n = 8). Results Age at PD catheter removal was significantly higher in D group compared to NC group (62.0 ± 10.6 vs 51.2 ± 11.5 years, p 〈 0.05). In addition, mean PD duration was significantly longer in E group compared to NC and A groups (130.5 ± 48.1 vs 58.8 ± 42.4 vs 74.8 ± 47.4 months, p 〈 0.01). Compared to baseline, effluent WBC was significantly decreased in NC group after 72 hours of peritonitis. In addition, serum CRP level was significantly decreased in NC and A groups, whereas it was significantly increased in D group. Multivariate analyses adjusted for age, PD duration, blood and effluent WBC, serum CRP, and micro-organisms revealed that serum CRP level at 72 hours predicted significantly the development of EPS [odds ratio (OR) 1.15, p 〈 0.05] and peritonitis-related death (OR 1.18, p 〈 0.01). In addition, PD duration (per 1 month increase: OR 1.03, p 〈 0.05) and age at PD catheter removal (per 1 year increase: OR 1.11, p 〈 0.05) were identified as significant determinants of EPS and peritonitis-related death respectively. Only effluent WBC at 72 hours was significantly associated with the development of ascites (OR 1.27, p 〈 0.05). Conclusion Older patients with long PD duration and those with persistently elevated serum CRP levels were likely to develop complications after peritonitis-related technique failure. Our study suggests that serial measurement of CRP may be helpful in predicting the development of complications after PD catheter removal.
    Type of Medium: Online Resource
    ISSN: 0896-8608 , 1718-4304
    URL: Article
    DOI: 10.1177/089686080802800409
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2008
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  • 9
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    Borderline Glenoid Bone Defect in Anterior Shoulder Instability: Latarjet Procedure Versus Bankart Repair
    SAGE Publications ; 2018
    In:  The American Journal of Sports Medicine Vol. 46, No. 9 ( 2018-07), p. 2170-2176
    Details
    In: The American Journal of Sports Medicine, SAGE Publications, Vol. 46, No. 9 ( 2018-07), p. 2170-2176
    Abstract: The optimal procedure for anterior shoulder instability with a borderline (15%-20%) bone defect on the anterior rim of the glenoid is still controversial. Purpose: To compare the clinical outcome and recurrence rate between the arthroscopic Bankart repair and Latarjet procedure among patients with recurrent anterior shoulder instability and a borderline glenoid bone defect. Study Design: Cohort study; Level of evidence, 3. Methods: The authors retrospectively reviewed cases of arthroscopic Bankart repair and the Latarjet procedure for recurrent anterior shoulder instability with a borderline (15%-20%) glenoid bone defect. Enrollment comprised 149 patients (Bankart group, n = 118; Latarjet group, n = 31). The mean follow-up and age at operation were 28.9 ± 7.3 months (range, 24-73 months) and 26 ± 5 years (range, 16-46 years), respectively. Results: Rowe and UCLA (University of California, Los Angeles) shoulder scores significantly improved from 42.0 ± 14.3 and 22.9 ± 3.2 preoperatively to 90.9 ± 15.4 and 32.5 ± 3.3 postoperatively in the Bankart group ( P 〈 .001) and from 41.0 ± 17.9 and 22.3 ± 3.4 to 91.1 ± 16.1 and 32.3 ± 3.4 in the Latarjet group ( P 〈 .001), respectively. There were no significant between-group differences in Rowe ( P = .920) or UCLA ( P = .715) scores at the final follow-up. Mean postoperative loss of motion during forward flexion, external rotation in abduction, and internal rotation to the posterior was 3.0° ± 6.2°, 11.6° ± 10.2°, and 0.6 spinal segment in the Bankart group and 3.7° ± 9.8°, 10.3° ± 12.8°, and 0.9 spinal segment in the Latarjet group, respectively. These differences were not significant. However, the loss of external rotation at the side was significantly greater in the Bankart group (13.3° ± 12.9°) than in the Latarjet group (7.3° ± 18.1°, P = .034). The overall recurrence rate was significantly higher in the Bankart group (22.9%) than in the Latarjet group (6.5%), ( P = .040). Conclusion: The Latarjet procedure and arthroscopic Bankart repair both provided satisfactory clinical outcome scores and pain relief for anterior shoulder instability with a borderline glenoid bone defect. However, the Latarjet procedure resulted in significantly lower recurrences and less external rotation limitation than the arthroscopic Bankart repair. Therefore, the Latarjet procedure could be a more reliable surgical option in anterior recurrent instability with a borderline glenoid bone defect.
    Type of Medium: Online Resource
    ISSN: 0363-5465 , 1552-3365
    URL: Article
    DOI: 10.1177/0363546518776978
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2018
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  • 10
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    Dual antiplatelet Use for extended period taRgeted to AcuTe ischemic stroke with presumed atherosclerotic OrigiN (DURATION) trial: Rationale and design
    SAGE Publications ; 2023
    In:  International Journal of Stroke Vol. 18, No. 8 ( 2023-10), p. 1015-1020
    Details
    In: International Journal of Stroke, SAGE Publications, Vol. 18, No. 8 ( 2023-10), p. 1015-1020
    Abstract: The optimal duration of dual antiplatelet therapy (DAPT) with clopidogrel-aspirin for the large artery atherosclerotic (LAA) stroke subtype has been debated. Aims: To determine whether the 1-year risk of recurrent vascular events could be reduced by a longer duration of DAPT in patients with the LAA stroke subtype. Methods and study design: A total of 4806 participants will be recruited to detect a statistically significant relative risk reduction of 22% with 80% power and a two-sided alpha error of 0.05, including a 10% loss to follow-up. This is a registry-based, multicenter, prospective, randomized, open-label, blinded end point study designed to evaluate the efficacy and safety of a 12-month duration of DAPT compared with a 3-month duration of DAPT in the LAA stroke subtype. Patients will be randomized (1:1) to either DAPT for 12 months or DAPT for 3 months, followed by monotherapy (either aspirin or clopidogrel) for the remaining 9 months. Study outcomes: The primary efficacy outcome of the study is a composite of stroke (ischemic or hemorrhagic), myocardial infarction, and all-cause mortality for 1 year after the index stroke. The secondary efficacy outcomes are (1) stroke, (2) ischemic stroke or transient ischemic attack, (3) hemorrhagic stroke, and (4) all-cause mortality. The primary safety outcome is major bleeding. Discussion: This study will help stroke physicians determine the appropriate duration of dual therapy with clopidogrel-aspirin for patients with the LAA stroke subtype. Trial registration: URL: https://cris.nih.go.kr/cris . CRIS Registration Number: KCT0004407
    Type of Medium: Online Resource
    ISSN: 1747-4930 , 1747-4949
    URL: Article
    DOI: 10.1177/17474930231168742
    Language: English
    Publisher: SAGE Publications
    Publication Date: 2023
    detail.hit.zdb_id: 2211666-7
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