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Ticagrelor versus clopidogrel after intracranial stent angioplasty: a real-world study
ConclusionIn our study involving patients with acute ischemic stroke who had undergone intracranial stenting, aspirin-ticagrelor was not found to be superior to aspirin-clopidogrel in reducing the rate of ischemic vascular events. The risk of bleeding did not differ between the two groups. Aspirin-ticagrelor does not lower total restenosis and symptomatic restenosis risk at follow-up.
Source: Frontiers in Neurology - August 11, 2023 Category: Neurology Source Type: research

Capsular warning syndrome and its clinical awareness and therapeutic approach: two case reports and a systematic review of the literature
ConclusionOur cases fit with the description of patients with partial recovery and risk factors (hypertension, diabetes, and smoking) in male patients. There is a lack of evidence regarding the best treatment option; dual antiplatelet therapy and anticoagulation therapy are strong contenders for a favorable result.
Source: Frontiers in Neurology - May 16, 2023 Category: Neurology Source Type: research

Efficacy and safety of low dose aspirin plus clopidogrel in the treatment of elderly patients with symptomatic intracranial artery stenosis
ConclusionIn this study, the safety of low dose aspirin combined with clopidogrel proved to be equally efficient and significantly safer than those of conventional dose within 24 months in elderly patients with sICAS. However, the small size of this study limits the validity of the results. Further larger longitudinal and randomized controlled trials are necessary to evaluate the role of low dose DAPT in the patients with sICAS.
Source: Frontiers in Neurology - March 2, 2023 Category: Neurology Source Type: research

Prospective pilot study of tirofiban in progressive stroke after intravenous thrombolysis
ConclusionEarly treatment with low-dose tirofiban in AIS patients with neurologic deterioration after IVT potentially improved functional recovery and attenuated neurologic deficits as early as 7 days and did not increase the risk of various hemorrhagic complications. However, the therapeutic efficacy of tirofiban treatment in END patients needs to be determined by future randomized clinical trials with a large study population.Clinical trial registrationhttp://www.chictr.org.cn/, Identifier ChiCTR2200058513.
Source: Frontiers in Neurology - October 4, 2022 Category: Neurology Source Type: research

Factors affecting physician decision-making regarding antiplatelet therapy in minor ischemic stroke
ConclusionsMany factors affect doctors' decisions regarding antiplatelet therapy, especially guidelines, age, admission SBP level, and hypertensive disease.
Source: Frontiers in Neurology - September 1, 2022 Category: Neurology Source Type: research

Platelet reactivity after clopidogrel loading in patients with acute ischemic stroke
ConclusionsResidual platelet reactivity at 24 h after clopidogrel loading was substantially higher in patients with AIS than in patients with other CVD. In addition, most patients with AIS were judged to be hypo-responders on PFT. This should be carefully interpreted in patients with AIS because of poor specificity for predicting clinical ischemic events.
Source: Frontiers in Neurology - August 24, 2022 Category: Neurology Source Type: research

Impact of Diabetes on Platelet Function in Acute Ischemic Stroke Patients Taking Dual Antiplatelet Therapy
Conclusions: In acute ischemic stroke patients taking DAPT, DM is associated with increased platelet reactivity and higher prevalence of clopidogrel HRPR.
Source: Frontiers in Neurology - November 4, 2021 Category: Neurology Source Type: research

Why Me? To Be an Ultra-Responder to Antiplatelet Therapy: A Case Report
Conclusion: The evaluation of platelet reactivity in stroke patients undergoing antiplatelet therapies, not commonly performed in clinical practice, could be useful to optimize prevention strategies; the verification of the biological effectiveness of ASA or Clopidogrel could be a valid tool in the definition of each patient's risk profile, particularly in patients with cerebrovascular disease known to be at increased risk for both hemorrhagic and thrombotic complications.
Source: Frontiers in Neurology - August 10, 2021 Category: Neurology Source Type: research

Clopidogrel Resistance in Patients With Stroke Recurrence Under Single or Dual Antiplatelet Treatment
Conclusions: HPR and clopidogrel resistance were more frequent in recurrent ischemic stroke patients receiving clopidogrel than in those receiving DAPT. Smoking was independently associated with less clopidogrel resistance among those receiving clopidogrel SAPT but not in those receiving DAPT.
Source: Frontiers in Neurology - August 10, 2021 Category: Neurology Source Type: research

Novel Predictors of Future Vascular Events in Post-stroke Patients —A Pilot Study
Conclusions: A combination of NAR reflecting the inflammatory state and AUCupper indicating HTPR may provide a better prediction of recurrent ischemic events suggesting a better selection of patients at risk, thus providing an individually tailored vascular therapy.
Source: Frontiers in Neurology - June 18, 2021 Category: Neurology Source Type: research

Biomarkers for Antiplatelet Therapies in Acute Ischemic Stroke: A Clinical Review
Stroke is one of the world's leading causes of disability and death. Antiplatelet agents are administered to acute ischemic stroke patients as secondary prevention. Clopidogrel involves biotransformation by cytochrome P450 (CYP) enzymes into an active metabolite, and single nucleotide polymorphisms (SNPs) can influence the efficacy of this biotransformation. Despite the therapeutic advantages of aspirin, there is significant inter-individual heterogeneity in response to this antiplatelet drug. In this clinical review, the recent advances in the biomarkers of antiplatelet agents in acute ischemic stroke are discussed. The s...
Source: Frontiers in Neurology - June 10, 2021 Category: Neurology Source Type: research

Clopidogrel Plus Aspirin in Patients With Different Types of Single Small Subcortical Infarction
Conclusions: There was no significant difference in the efficacy of clopidogrel plus aspirin compared with aspirin alone between patients with SSSI + PAD and SSSI – PAD in the CHANCE trial. Studies in other populations and with adequate power are needed to further verify such findings.
Source: Frontiers in Neurology - March 29, 2021 Category: Neurology Source Type: research

Antiplatelet Therapy in the Secondary Prevention of Non-cardioembolic Ischemic Stroke and Transient Ischemic Attack: A Mini-Review
The aim of this mini-review is to discuss the main antiplatelet agents that have been successfully used in the secondary prevention of non-cardioembolic ischemic stroke and transient ischemic attacks (TIA). The methodology is based on a literature review of available peer-reviewed English studies listed in PubMed. The findings reveal that aspirin remains a reliable antiplatelet agent in the secondary prevention of acute non-cardioembolic ischemic stroke and TIA. Nevertheless, currently, there are also other agents, i.e., ticagrelor, clopidogrel, and cilostazol, that can be applied. In addition, the results indicate that ti...
Source: Frontiers in Neurology - February 25, 2021 Category: Neurology Source Type: research

Pre-treatment of Single and Double Antiplatelet and Anticoagulant With Intravenous Thrombolysis for Older Adults With Acute Ischemic Stroke: The TTT-AIS Experience
Conclusion: For older adults with higher baseline severity of acute ischemic stroke, DAPP may increase the risk of SICH and mortality post IVT. However, DAPP is still not an indication to withdraw IVT and to prescribe low-dose IVT for older adults.
Source: Frontiers in Neurology - February 22, 2021 Category: Neurology Source Type: research

Hybrid Recanalization for the Treatment of Carotid/Vertebral In-stent Restenosis or Occlusion: Pilot Surgery Experiences From One Single Center
Conclusion : The hybrid technique maybe a safe and feasible treatment option to recanalize in-stent restenosis or occlusion with acceptable complications.
Source: Frontiers in Neurology - November 24, 2020 Category: Neurology Source Type: research

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