{
  "abstract": "BackgroundAntiplatelet selection is challenging in patients with acute ischemic stroke (AIS), gout, and hyperuricemia. We compared the risk of in-hospital gout flares between aspirin-containing regimens and clopidogrel monotherapy, and examined subsequent aspirin discontinuation during dual antiplatelet therapy (DAPT).\n\nMethodsA retrospective new-user cohort study was conducted based on electronic medical records (2019-2025). Patients were categorized into aspirin-containing therapy (aspirin monotherapy or DAPT with aspirin plus clopidogrel) and clopidogrel monotherapy groups. The primary analysis used IPTW-adjusted logistic regression. Interaction tests assessed effect modification and a Sankey diagram visualized DAPT treatment transition.\n\nResultsAmong 105,890 screened patients, 457 were enrolled (234 aspirin-containing therapy, 223 clopidogrel monotherapy). In-hospital gout flares occurred in 187 (40.9%). Aspirin-containing regimens were associated with a higher flare risk (OR = 1.57, 95% CI 1.07 - 2.31, P = 0.022). Results were consistent in sensitivity analyses. Higher SUA (OR 1.20 per 1-mg/dL increase, 95% CI 1.03-1.40; P = 0.023) and baseline mRS [≥]3 (OR 2.13, 95% CI 1.42-3.20; P < 0.001) were independently associated with in-hospital gout flares. No significant interactions were observed between antiplatelet regimens and SUA, mRS or urate-lowering therapy (ULT). Among DAPT recipients, aspirin discontinuation in patients with gout flares was 65.2%, 66.7%, and 56.0% in 2019-2021, 2022-2023, and 2024-2025, respectively, versus 47.8%, 28.6%, and 11.9% in those without flares.\n\nConclusionsIn AIS patients with gout and hyperuricemia, initiating aspirin-containing regimens was associated with a higher risk of in-hospital gout flares compared with clopidogrel monotherapy. Gout flares during DAPT were accompanied by frequent aspirin discontinuation, which may limit completion of guideline-recommended DAPT. Prospective studies are needed.",
  "abstract_shown": true,
  "affiliations": [
    "Tianjin Huanhu Hospital"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "name": "A. Ma"
    },
    {
      "affs": [
        0
      ],
      "name": "X. Xu"
    },
    {
      "name": "Y. Zhang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/d0v80fthq9s53.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.10.23.26366257",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.10.23.26366257v1.full",
  "id": "d0v80fthq9s53",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.10.23.26366257v1",
  "language": null,
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "neurology"
    ],
    [
      "openalex",
      "2705|Antiplatelet Therapy and Cardiovascular Diseases"
    ]
  ],
  "openalex": "W7223664895",
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.10.23.26366257v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-23",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/d0v80fthq9s53.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:21:46Z",
      "native_id": "10.64898/2026.10.23.26366257",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.10.23.26366257v1"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:neurology",
      "subfield": "neurology"
    }
  ],
  "title": "Aspirin-Containing Antiplatelet Therapy and In-Hospital Gout Flares in Acute Ischemic Stroke Patients with Gout and Hyperuricemia: A Retrospective New-User Cohort Study",
  "title_text": "Aspirin-Containing Antiplatelet Therapy and In-Hospital Gout Flares in Acute Ischemic Stroke Patients with Gout and Hyperuricemia: A Retrospective New-User Cohort Study",
  "type": "preprint",
  "updated_at": "2026-10-30T12:21:46Z",
  "url": "https://research.draconitic.com/paper/d0v80fthq9s53",
  "venue": "medRxiv",
  "versions": []
}