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Clopidogrel Resistance after Minor Ischemic Stroke or Transient Ischemic Attack is Associated with Radiological Cerebral Small-Vessel Disease
The objective of this study was to compare nonresponders (NR) and responders (R) to clopidogrel with respect to presence of microvascular and macrovascular pathology in a cohort of patients with recent minor ischemic stroke (IS) or transient ischemic attack (TIA).
Source: Journal of Stroke and Cerebrovascular Diseases - August 23, 2015 Category: Neurology Authors: Annika Lundström, Håkan Wallén, Magnus von Arbin, Gun Jörneskog, Bruna Gigante, Karin Höeg embrower, Evaldas Laurencikas, Ann Charlotte Laska Source Type: research

Relationship between Inflammation and Aspirin and Clopidogrel Antiplatelet Responses in Acute Ischemic Stroke
We measured serum levels of proinflammatory/prothrombotic markers P-selectin, CD40L, matrix metalloproteinase 9 (MMP-9), intracellular adhesion molecule 1 (ICAM-1), and interleukin (IL)-6 in ischemic stroke patients, correlating their levels with the results of aspirin (ASA) and clopidogrel antiplatelet responses, using 3 “point of care” platelet function instruments, thromboelastograph (TEG), Accumetrics (ACU), and impedance aggregometer (IMP).
Source: Journal of Stroke and Cerebrovascular Diseases - November 12, 2015 Category: Neurology Authors: Zohara Sternberg, Trevor Chichelli, Daniel Sternberg, Robert Sawyer, Marilou Ching, David Janicke, Julian L. Ambrus, Jinhee Yu, Frederick Munschauer Source Type: research

Clopidogrel Resistance Increases Rate of Recurrent Stroke and Other Vascular Events in Chinese Population
Research regarding clopidogrel resistance (CR) and ischemic stroke (IS) recurrence related to IS is scanty. The aim of the present study was to determine the incidence of CR and the association between CR and IS recurrence and other vascular events in patients with IS receiving clopidogrel.
Source: Journal of Stroke and Cerebrovascular Diseases - February 26, 2016 Category: Neurology Authors: Xingyang Yi, Jing Lin, Qiang Zhou, Lang Wu, Wen Cheng, Chun Wang Source Type: research

Concomitant Use of Proton Pump Inhibitors and Clopidogrel Is Not Associated with Adverse Outcomes after Ischemic Stroke in Chinese Population
Conflicting data exist as to whether proton pump inhibitors (PPIs) diminish the efficacy of clopidogrel. We, therefore, assessed the effect of concomitant PPI use in ischemic stroke (IS) patients receiving clopidogrel.
Source: Journal of Stroke and Cerebrovascular Diseases - August 17, 2016 Category: Neurology Authors: Xingyang Yi, Qiang Zhou, Chun Wang, Jing Lin, Wen Cheng, Lifen Chi Source Type: research

High on-clopidogrel platelet reactivity in ischaemic stroke or transient ischaemic attack: Systematic review and meta-analysis
To assess the prevalence of high on-clopidogrel platelet reactivity (HCPR) in patients with ischaemic stroke or transient ischaemic attack (IS/TIA), their outcome and genetic basis of on-treatment response variability in IS/TIA patients.
Source: Journal of Stroke and Cerebrovascular Diseases - May 13, 2020 Category: Neurology Authors: Vafa Alakbarzade, Xuya Huang, Irina Chis Ster, Meriel McEntagart, Anthony C. Pereira Source Type: research

CYP2C19 Loss-of-Function is Associated with Increased Risk of Ischemic Stroke after Transient Ischemic Attack in Intracranial Atherosclerotic Disease
Intracranial atherosclerotic disease (ICAD) is responsible for 8-10% of acute ischemic strokes, and resistance to antiplatelet therapy is prevalent. CYP2C19 gene loss-of-function (up to 45% of patients) causes clopidogrel resistance. For patients with asymptomatic ICAD and ICAD characterized by transient ischemic attack (TIA), this study measures the effect of CYP2C19 loss-of-function on ischemic stroke risk during clopidogrel therapy.
Source: Journal of Stroke and Cerebrovascular Diseases - November 24, 2020 Category: Neurology Authors: Pious D. Patel, Praveen Vimalathas, Xinnan Niu, Chevis N. Shannon, Joshua C. Denny, Josh F. Peterson, Rohan V. Chitale, Matthew R. Fusco Source Type: research

Antiplatelet Therapy as a Risk Factor for Microbleeds in Intracerebral Hemorrhage Patients: Analysis Using Specific Antiplatelet Agents
Conclusions: Attention to microbleed-positive patients is necessary for the safe use of aspirin in order to avoid antiplatelet-associated hemorrhages, but prospective studies are needed to verify our results.
Source: Journal of Stroke and Cerebrovascular Diseases - July 12, 2012 Category: Neurology Authors: Hiromitsu Naka, Eiichi Nomura, Jyuri Kitamura, Eiji Imamura, Shinichi Wakabayashi, Masayasu Matsumoto Tags: Original Articles Source Type: research

The Effect of Cilostazol on Carotid Intima–Media Thickness Progression in Patients with Symptomatic Intracranial Atherosclerotic Stenosis
Conclusion: Cilostazol has a beneficial effect in preventing the progression of CIMT in ischemic stroke patients.
Source: Journal of Stroke and Cerebrovascular Diseases - December 9, 2013 Category: Neurology Authors: Bum Joon Kim, Joung-Ho Rha, Seong Rae Kim, Dong-Eog Kim, Hahn Young Kim, Ju-Hun Lee, Hee-Joon Bae, Moon-Ku Han, Dong-Wha Kang, Disya Ratanakorn, Jong S. Kim, Sun U. Kwon Tags: Original Articles Source Type: research

Clinical Features and Racial/Ethnic Differences Among the 3020 Participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) Trial
This study examined the baseline characteristics, racial/ethnic differences, and geographic differences among participants in the Secondary Prevention of Small Subcortical Strokes (SPS3) study. The SPS3 trial enrolled patients who experienced a symptomatic small subcortical stroke (lacunar stroke) within the previous 6 months and an eligible lesion on detected on magnetic resonance imaging. The patients were randomized, in a factorial design, to antiplatelet therapy (aspirin 325 mg daily plus clopidogrel 75 mg daily vs aspirin 325 mg daily plus placebo) and to one of two levels of systolic blood pressure targets (“intensive” [
Source: Journal of Stroke and Cerebrovascular Diseases - April 19, 2012 Category: Neurology Authors: Carole L. White, Jeff M. Szychowski, Ana Roldan, Marie-France Benavente, Edwin J. Pretell, Oscar H. Del Brutto, Carlos S. Kase, Antonio Arauz, Brett C. Meyer, Irene Meissner, Bart M. Demaerschalk, Leslie A. McClure, Christopher S. Coffey, Lesly A. Pearce, Tags: Original Articles Source Type: research

Prospective Registry of Carotid Artery Stenting in Japan—Investigation on Device and Antiplatelet for Carotid Artery Stenting
Background: Carotid artery stenting (CAS) is minimally invasive but may cause perioperative cerebral infarction associated with distal embolization. We conducted a multicenter prospective observational study on the onset of vascular events after CAS to find out the efficacy and safety of CAS in Japan and to investigate the effects of antiplatelet drugs administered before and after CAS on efficacy and safety of CAS.Methods: A total of 949 patients with cervical carotid artery stenosis were enrolled at 43 institutions in Japan; 934 who had undergone CAS with antiplatelet drugs and followed for 1 year were analyzed. Primary ...
Source: Journal of Stroke and Cerebrovascular Diseases - February 19, 2014 Category: Neurology Authors: Nobuyuki Sakai, Hiroshi Yamagami, Yoshihiro Matsubara, Masayuki Ezura, Akio Hyodo, Yuji Matsumaru, Shigeru Miyachi, Yasushi Okada, Tomoaki Terada, Hiroyoshi Yokoi, Mitusugu Nakamura, Yasushi Matsumoto, Chiaki Sakai, IDEALCAST Investigators Tags: Original Articles Source Type: research

Safety Evaluation of Substituting Clopidogrel for Ticlopidine in Japanese Patients with Ischemic Stroke—Hiroshima Ticlopidine, Clopidogrel Safe Exchange Trial
Conclusions: The adverse event rates after the substitution of ticlopidine for clopidogrel is similar to the adverse event rates of patients who were initially treated with clopidogrel. The substitution of clopidogrel for ticlopidine should be considered for patients who develop hematologic abnormalities from ticlopidine treatment.
Source: Journal of Stroke and Cerebrovascular Diseases - February 21, 2014 Category: Neurology Authors: Tatsuo Kohriyama, Chie Mihara, Takakazu Yokoyama, Tsuyoshi Torii, Atsuo Yamada, Kazuhiro Takamatsu, Taisei Ota, Kouichi Noda, Satoshi Kataoka, Hijiri Ito, Eiichi Nomura, Toshiho Ohtsuki, Shiro Aoki, Tomohisa Nezu, Ikuko Takeda, Tomoya Mukai, Naohisa Hosom Tags: Original Articles Source Type: research

Reduced Clopidogrel Metabolism in a Multiethnic Population: Prevalence and Rates of Recurrent Cerebrovascular Events
Conclusions: These data suggest that the proportion of poor/intermediate clopidogrel metabolizers in cerebrovascular patients is comparable to cardiovascular studies and these patients may have an increased risk of recurrent cerebrovascular events. Routine CYP2C19 testing may be warranted.
Source: Journal of Stroke and Cerebrovascular Diseases - July 15, 2013 Category: Neurology Authors: Ilana Spokoyny, Nobl Barazangi, Victor Jaramillo, Jack Rose, Charlene Chen, Christine Wong, David Tong Tags: Original Articles Source Type: research

Platelet Function Monitoring Performed after Carotid Stenting during Endovascular Stroke Treatment Predicts Outcome
Antiplatelets agents are widely used and effective for secondary prevention of vascular diseases. Some patients might have reduced platelet inhibition on antiplatelet therapy with a higher risk of ischemic complications.1,2 The role of platelet function monitoring (PFM) has been extensively investigated in cardiology. Resistance to Clopidogrel correlates with higher risk of long-term cardiovascular events and coronary stent thrombosis.3,4 Similarly, studies performed after elective carotid stenting showed that ischemic recurrence and early stent thrombosis are more common in non-responders to Clopidogrel.
Source: Journal of Stroke and Cerebrovascular Diseases - May 5, 2021 Category: Neurology Authors: Ludovico Ciolli, Nicoletta Lelli, Francesca Rosafio, Stefania Maffei, Federico Sacchetti, Laura Vandelli, Maria Luisa Dell'Acqua, Livio Picchetto, Giuseppe Maria Borz ì, Riccardo Ricceri, Roberta Pentore, Manuela Tondelli, Gabriele Vandelli, Noelia Rodr� Source Type: research

Under Treatment of High-Risk TIA Patients with Clopidogrel-Aspirin in the Emergency Setting
Treating high-risk transient ischemic attack (TIA) with dual antiplatelet therapy (DAPT) reduces subsequent ischemic stroke risk yet current rates of clopidogrel-aspirin treatment are uncertain.
Source: Journal of Stroke and Cerebrovascular Diseases - October 11, 2021 Category: Neurology Authors: Andrea R. Lendaris, Samantha Lessen, Natalie T. Cheng, Benjamin W. Friedman, Charles Esenwa, Daniel L. Labovitz, Shyam Prabhakaran, Richard B. Lipton, Ava L. Liberman Source Type: research

Loading Dose of Clopidogrel in Combination with Other Antithrombotic Therapy for Capsular Warning Syndrome
A 66-year-old man had repeated stereotypical transient ischemic attacks (TIAs) of dysarthria and left hemiparesis. His symptoms were considered capsular warning syndrome (CWS), for which the responsible lesion was found on magnetic resonance imaging to be in the right putamen expanding to the corona radiata. Although administration of antithrombotic therapy including aspirin was ineffective, no further TIAs occurred after a loading dose of clopidogrel was added. A loading dose of clopidogrel combined with other antithrombotic therapy might be an effective treatment for CWS.
Source: Journal of Stroke and Cerebrovascular Diseases - October 17, 2013 Category: Neurology Authors: Hiroyuki Kawano, Makoto Nakajima, Yuichiro Inatomi, Toshiro Yonehara, Yukio Ando Tags: Case Reports Source Type: research

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