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Drug: Clopidogrel

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Total 1913 results found since Jan 2013.

A Comparative Study of Dual versus Monoantiplatelet Therapy in Patients with Acute Large-Artery Atherosclerosis Stroke
Background: Antiplatelet drugs are recommended for patients with acute noncardioembolic stroke. However, few randomized clinical trials have investigated the safety and efficacy of dual antiplatelet therapy for these patients. The aim of this study was to evaluate the effects of treatment with clopidogrel and aspirin (combination therapy) and aspirin alone (monotherapy) on neurologic deterioration, platelet activation, and other short-term outcomes in patients with acute large-artery atherosclerosis stroke.Materials and Methods: Altogether 574 patients with acute (≤2 days) large-artery atherosclerosis stroke were random...
Source: Journal of Stroke and Cerebrovascular Diseases - April 15, 2014 Category: Neurology Authors: Xingyang Yi, Jing Lin, Chun Wang, Biao Zhang, Wanzhang Chi Tags: Original Articles Source Type: research

Safety and Effectiveness of Intravenous Recombinant Tissue Plasminogen Activator in Acute Ischemic Stroke Patients on Aspirin and Clopidogrel (P4.284)
CONCLUSIONS: Compared with patients on no antiplatelet treatment, acute ischemic stroke patients who are actively using aspirin and clopidogrel appear to have similar risks and benefits with IV rt-PA treatment.Disclosure: Dr. Qureshi has nothing to disclose. Dr. Khan has nothing to disclose. Dr. Jahangir has nothing to disclose. Dr. Malik has nothing to disclose. Dr. Thampson has nothing to disclose. Dr. Khan has nothing to disclose. Dr. Suri has nothing to disclose. Dr. Qureshi has nothing to disclose.
Source: Neurology - April 8, 2015 Category: Neurology Authors: Qureshi, M., Khan, S., Jahangir, N., Malik, A., Thampson, M., Khan, A., Suri, M., Qureshi, A. Tags: Cerebrovascular Disease and Interventional Neurology: Acute Ischemic Stroke Care Source Type: research

Safety and efficacy of intensive vs. guideline antiplatelet therapy in high‐risk patients with recent ischemic stroke or transient ischemic attack: rationale and design of the Triple Antiplatelets for Reducing Dependency after Ischaemic Stroke (TARDIS) trial (ISRCTN47823388)
DiscussionThe trial has recruited more than 50% of its target sample size (latest number: 2399) and is running in 104 sites in 4 countries. One‐third of patients presented with a transient ischemic attack.
Source: International Journal of Stroke - June 16, 2015 Category: Neurology Tags: Protocol Source Type: research

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

Clopidogrel Use Is Associated With an Increased Prevalence of Cerebral Microbleeds in a Stroke-Free Population: The Rotterdam Study Stroke
Conclusions In stroke-free individuals, clopidogrel use was associated with a higher prevalence and higher number of CMBs. Whether this association is causal requires confirmation in prospective studies, especially given the small number of participants taking clopidogrel and the possibility of residual confounding in this study.
Source: JAHA:Journal of the American Heart Association - September 26, 2013 Category: Cardiology Authors: Darweesh, S. K. L., Leening, M. J. G., Akoudad, S., Loth, D. W., Hofman, A., Arfan Ikram, M., Vernooij, M. W., Stricker, B. H. Tags: Stroke Source Type: research

Aspirin plus clopidogrel in acute minor ischaemic stroke or transient ischaemic attack is superior to aspirin alone for stroke risk reduction: CHANCE trial
Commentary on: Wang Y, Wang Y, Zhao X, et al.. Clopidogrel with aspirin in acute minor stroke or transient ischemic attack. N Engl J Med 2013;369:11–19. Context Combination therapy with aspirin added to clopidogrel has had a disappointing record in the prevention of recurrent stroke. The management of atherothrombosis with clopidogrel in high-risk patients (MATCH)1 and the secondary prevention of small subcortical strokes (SPS3)2 randomised controlled trials (RCTs) showed that combination therapy was not more effective than clopidogrel or aspirin alone, but was associated with two to three times the risk of major or ...
Source: Evidence-Based Medicine - March 19, 2014 Category: Internal Medicine Authors: Gorelick, P. B., Farooq, M. U. Tags: Smoking and tobacco, Clinical trials (epidemiology), Genetics, Stroke, Hypertension, Diabetes, Health education, Smoking Therapeutics Source Type: research

Meta-analysis finds benefit for dual antiplatelet therapy but limitations preclude changing standard mono antiplatelet therapy approach for acute non-cardioembolic ischaemic stroke or transient ischaemic attack
Commentary on: Wong KSL, Wang Y, Leng X, et al.. Early dual versus mono antiplatelet therapy for acute non-cardioembolic ischemic stroke or transient ischemic attack. An updated systematic review and meta-analysis. Circulation 2013;128:1656–66. Context Current guidelines recommend aspirin, aspirin plus clopidogrel or aspirin plus extended-release dipyridamole for treatment of acute ischaemic stroke (IS) or transient ischaemic attack (TIA) to prevent recurrent stroke, myocardial infarction and cardiovascular death.1 The Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events (CHANCE) trial ra...
Source: Evidence-Based Medicine - May 19, 2014 Category: Internal Medicine Authors: Aronow, W. S. Tags: Clinical trials (epidemiology), Epidemiologic studies, Drugs: cardiovascular system, Stroke, Ischaemic heart disease Therapeutics 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