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Specialty: Neurology
Drug: Clopidogrel

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Total 367 results found since Jan 2013.

Predicting major bleeding in patients with noncardioembolic stroke on antiplatelets: S2TOP-BLEED
Conclusions: The S2TOP-BLEED score can be used to estimate 3-year major bleeding risk in patients with a TIA or ischemic stroke who use antiplatelet agents, based on readily available characteristics. The discriminatory performance may be improved by identifying stronger predictors of major bleeding.
Source: Neurology - August 28, 2017 Category: Neurology Authors: Hilkens, N. A., Algra, A., Diener, H.-C., Reitsma, J. B., Bath, P. M., Csiba, L., Hacke, W., Kappelle, L. J., Koudstaal, P. J., Leys, D., Mas, J.-L., Sacco, R. L., Amarenco, P., Sissani, L., Greving, J. P., For the Cerebrovascular Antiplatelet Trialists' Tags: Stroke prevention, All Cerebrovascular disease/Stroke, Risk factors in epidemiology, Infarction ARTICLE Source Type: research

Proteinuria Predicts Resistance to Antiplatelet Therapy in Ischemic Stroke
AbstractThe occurrence of a stroke while on antiplatelet agents presents a therapeutic dilemma. One of the main causes for recurrent strokes is antiplatelet resistance more commonly known as high on treatment platelet reactivity (HTPR). Prior studies have established that proteinuria is associated with HTPR following myocardial infarction. Here, we investigated whether dipstick proteinuria correlates with HTPR in patients presenting with stroke. We performed a retrospective cohort analysis of 102 patients admitted for a recurrent ischemic stroke that had either a VerifyNow aspirin or VerifyNow clopidogrel laboratory test p...
Source: Translational Stroke Research - September 5, 2017 Category: Neurology Source Type: research

High On-Treatment Platelet Reactivity as Predictor of Long-term Clinical Outcomes in Stroke Patients with Antiplatelet Agents
AbstractThe purpose was to explore the value of high on-treatment platelet reactivity (HTPR) in predicting long-term clinical outcomes for stroke patients. The platelet reactivity was assayed after being treated with either 75  mg clopidogrel or 100 mg aspirin daily with VerifyNow System in stroke patients. HTPR for clopidogrel was defined as PRU ≥ 208, and that for aspirin was defined as ARU ≥ 550. CYP2C19 genotyping was performed using the Sequenom MassARRAY iPLEX platform. The primary endpoint was a compo site of recurrent ischemic stroke, transient ischemic attack, myocardial infarction, or ischemic vascu...
Source: Translational Stroke Research - October 1, 2021 Category: Neurology Source Type: research

Prior antiplatelet agent use and outcomes after intravenous thrombolysis with recombinant tissue plasminogen activator in acute ischemic stroke: a meta‐analysis of cohort studies and randomized controlled trials
ConclusionsIn acute ischemic stroke patients receiving intravenous recombinant tissue plasminogen activator therapy, prior antiplatelet agent use did not lead to a significant difference in functional outcome, although it significantly increased the risk of symptomatic intracranial hemorrhage. Recanalization rate was not different between two groups. In the subgroup analysis, prior clopidogrel mono therapy may not increase the risk of symptomatic intracranial hemorrhage, which will need further studies to confirm.
Source: International Journal of Stroke - December 25, 2014 Category: Neurology Authors: Xiding Pan, Yubing Zhu, Danni Zheng, Yukai Liu, Feng Yu, Jie Yang Tags: Review Source Type: research

Association of Lp-PLA2-A and early recurrence of vascular events after TIA and minor stroke
Conclusions: Higher levels of Lp-PLA2-A in the acute period are associated with increased short-term risk of recurrent vascular events.
Source: Neurology - November 2, 2015 Category: Neurology Authors: Lin, J., Zheng, H., Cucchiara, B. L., Li, J., Zhao, X., Liang, X., Wang, C., Li, H., Mullen, M. T., Johnston, S. C., Wang, Y., Wang, Y., On behalf of the CHANCE investigators Tags: Other cerebrovascular disease/ Stroke ARTICLE Source Type: research

TRAF3 Epigenetic Regulation Is Associated With Vascular Recurrence in Patients With Ischemic Stroke Clinical Sciences
Conclusions— This study suggests for the first time that epigenetics may significantly contribute to the variability of clopidogrel response and recurrence of ischemic events in patients with stroke.
Source: Stroke - April 24, 2016 Category: Neurology Authors: Gallego-Fabrega, C., Carrera, C., Reny, J.-L., Fontana, P., Slowik, A., Pera, J., Pezzini, A., Serrano-Heras, G., Segura, T., Marti-Fabregas, J., Muino, E., Cullell, N., Montaner, J., Krupinski, J., Fernandez-Cadenas, I. Tags: Epigenetics Clinical Sciences Source Type: research

Aspirin Versus Clopidogrel for Type 2 Diabetic Patients with First-Ever Noncardioembolic Acute Ischemic Stroke: Ten-Year Survival Data from the Athens Stroke Outcome Project
Diabetes mellitus is associated with an increased risk of stroke and poor outcome following a stroke event. We assessed the impact of discharge treatment with aspirin versus clopidogrel on the 10-year survival of patients with type 2 diabetes after a first-ever noncardioembolic acute ischemic stroke (AIS).
Source: Journal of Stroke and Cerebrovascular Diseases - July 28, 2017 Category: Neurology Authors: Haralampos Milionis, George Ntaios, Vasileios Papavasileiou, Konstantinos Spengos, Efstathios Manios, Moses Elisaf, Konstantinos Vemmos Source Type: research

Role of CYP2C19 alleles in the management of recurrent ischemic stroke
Purpose of review CYP2C19 is the primary enzyme involved in the activation of clopidogrel, an antiplatelet agent used for secondary stroke prevention. An individual's CYP2C19 alleles are used to understand their CYP2C19-clopidogrel metabolizer phenotype. Single nucleotide polymorphisms of the CYP2C19 gene result in altered metabolism of this prodrug. Recent findings Three ischemic stroke cases were treated with clopidogrel. Despite confirming adequate drug exposure, medication adherence, and ruling out drug-drug interactions, all had recurrent ischemic stroke. Each case had a CYP2C19 *2/*17 genotype, categorizing them as ...
Source: Neurology Clinical Practice - April 7, 2019 Category: Neurology Authors: Lyerly, M. J., Bartlett, K., Albright, K. C. Tags: All Cerebrovascular disease/Stroke, Infarction, All Genetics Review Source Type: research

Ipsilateral Nonstenotic Carotid Disease in Minor Ischemic Stroke: an Exploratory Analysis of The POINT Randomized Clinical Trial
Dual antiplatelet therapy, with combination aspirin and clopidogrel, is now standard of care in the secondary prevention of minor stroke and transient ischemic attack1 –3 as well as stroke due to intracranial atherosclerotic disease.4 However, in the Clopidogrel in High-risk patients with Acute Nondisabling Cerebrovascular Events (CHANCE)2 and Platelet Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT)3 randomized clinical trials, determination of the etiology of ischemic stroke was not required to initiate secondary prevention.
Source: Journal of Stroke and Cerebrovascular Diseases - August 13, 2020 Category: Neurology Authors: Zachary Bulwa, Faddi G. Saleh Velez, James R. Brorson, Camila B. Pinto Source Type: research

Prevalence of Ex Vivo High On-treatment Platelet Reactivity on Antiplatelet Therapy after Transient Ischemic Attack or Ischemic Stroke on the PFA-100® and VerifyNow®
Background: The prevalence of ex vivo high on-treatment platelet reactivity (HTPR) to commonly prescribed antiplatelet regimens after transient ischemic attack (TIA) or ischemic stroke is uncertain.Methods: Platelet function inhibition was simultaneously assessed with modified light transmission aggregometry (VerifyNow; Accumetrics Inc, San Diego, CA) and with a moderately high shear stress platelet function analyzer (PFA-100; Siemens Medical Solutions USA, Inc, Malvern, PA) in a pilot, cross-sectional study of TIA or ischemic stroke patients. Patients were assessed on aspirin–dipyridamole combination therapy (n = 51) o...
Source: Journal of Stroke and Cerebrovascular Diseases - September 14, 2012 Category: Neurology Authors: Justin A. Kinsella, W. Oliver Tobin, Dermot Cox, Tara Coughlan, Ronan Collins, Desmond O’Neill, Raymond P. Murphy, Dominick J.H. McCabe Tags: Original Articles Source Type: research

Hemorrhagic Risk of Emergent Endovascular Treatment Plus Stenting in Patients with Acute Ischemic Stroke
Conclusions: Our findings suggest that emergent stenting in endovascular treatment of AIS is associated with SICH.
Source: Journal of Stroke and Cerebrovascular Diseases - January 24, 2013 Category: Neurology Authors: Laura Dorado, Carlos Castaño, Mònica Millán, Aitziber Aleu, Natàlia Pérez de la Ossa, Meritxell Gomis, Elena López-Cancio, Elio Vivas, Ana Rodriguez-Campello, Mar Castellanos, Antoni Dávalos Tags: Original Articles Source Type: research

Protocol for Cilostazol Stroke Prevention Study for Antiplatelet Combination (CSPS.com): a randomized, open‐label, parallel‐group trial
DiscussionThe CSPS.com is expected to provide evidence indicating whether secondary IS prevention in high‐risk patients can be improved by using DAPT involving cilostazol.
Source: International Journal of Stroke - December 8, 2014 Category: Neurology Authors: Kazunori Toyoda, Shinichiro Uchiyama, Haruhiko Hoshino, Kazumi Kimura, Hideki Origasa, Hiroaki Naritomi, Kazuo Minematsu, Takenori Yamaguchi, Tags: Protocols Source Type: research

Relationship Between Degree of Left Ventricular Dysfunction, Symptom Status, and Risk of Embolic Events in Patients With Atrial Fibrillation and Heart Failure Clinical Sciences
Conclusion— Among HF patients in ACTIVE, neither the presence of LVSD or degree of symptom severity influenced risk of embolic events.
Source: Stroke - February 23, 2015 Category: Neurology Authors: Sandhu, R. K., Hohnloser, S. H., Pfeffer, M. A., Yuan, F., Hart, R. G., Yusuf, S., Connolly, S. J., McAlister, F. A., Healey, J. S. Tags: Congestive, Arrhythmias, clinical electrophysiology, drugs, Embolic stroke Clinical Sciences Source Type: research

Platelet Function Testing in Patients with Acute Ischemic Stroke: An Observational Study
The measurement of platelet reactivity in patients with stroke undergoing antiplatelet therapies is not commonly performed in clinical practice. We assessed the prevalence of therapy responsiveness in patients with stroke and further investigated differences between patients on prevention therapy at stroke onset and patients naive to antiplatelet medications. We also sought differences in responsiveness between etiological subtypes and correlations between Clopidogrel responsiveness and genetic polymorphisms.
Source: Journal of Stroke and Cerebrovascular Diseases - May 30, 2017 Category: Neurology Authors: Francesca Rosafio, Nicoletta Lelli, Stefano Mimmi, Laura Vandelli, Guido Bigliardi, Maria Luisa Dell'Acqua, Livio Picchetto, Roberta Pentore, Diana Ferraro, Tommaso Trenti, Paolo Nichelli, Andrea Zini Source Type: research

Secondary Stroke Prophylaxis with Clopidogrel Produces Sufficient Antiplatelet Response
Antiplatelet therapy is a cornerstone prevention strategy for secondary ischemic stroke (IS) and transient ischemic attack (TIA). Yet, a proportion of patients who receive antiplatelet therapy experience recurrent ischemic cerebrovascular events. A recent meta-analysis found an increased risk of recurrent stroke in clopidogrel- or aspirin-treated patients with ischemic stroke who had high on-treatment platelet reactivity (HTPR). Few studies have focused specifically on clopidogrel HTPR. Therefore, the aim of this study was to examine the relationship between clopidogrel HTPR and recurrent ischemic events in a population of...
Source: Journal of Stroke and Cerebrovascular Diseases - June 23, 2018 Category: Neurology Authors: Charlotte L ützhøft Rath, Niklas Rye Jørgensen, Troels Wienecke Source Type: research