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Contemporary Antiplatelet and Anticoagulant Therapies for Secondary Stroke Prevention: A Narrative Review of Current Literature and Guidelines
AbstractPurpose of ReviewStroke is a leading cause of death and disability worldwide. The annual incidence of new or recurrent stroke is approximately 795,000 cases per year in the United States, of which 87% are ischemic in nature. In addition to the management of modifiable high-risk factors to reduce the risk of recurrent stroke, antithrombotic agents (antiplatelets and anticoagulants) play an important role in secondary stroke prevention. This review will discuss the published literature on the use of antiplatelets and anticoagulants in secondary prevention of acute ischemic stroke and transient ischemic attack (TIA), ...
Source: Current Neurology and Neuroscience Reports - April 11, 2023 Category: Neuroscience Source Type: research

Navigating Antiplatelet Treatment Options for Stroke: Evidence-Based and Pragmatic Strategies
AbstractPurpose of ReviewThe benefit of using antiplatelet monotherapy in acute ischemic stroke and secondary stroke prevention is well established. In the last few years, several large randomized trials showed that the use of short-term dual antiplatelet therapy in particular stroke subtypes may reduce the risk of recurrent ischemic events. The aim of this article is to provide a critical analysis of the current evidence and recommendations for the use of antiplatelet agents for stroke prevention.Recent FindingsLong-term therapy with aspirin, clopidogrel, or aspirin plus extended-release dipyridamole is recommended for se...
Source: Current Neurology and Neuroscience Reports - October 13, 2022 Category: Neuroscience Source Type: research

Oleuropein Protects Against Cerebral Ischemia Injury in Rats: Molecular Docking, Biochemical and Histological Findings
This study was designed to evaluate the underlying protective mechanisms of oleuropein involved in alleviating brain damage in a rat model of ischemic stroke. Male Wistar rats were divided into four groups; Control, stroke (MCAO), MCAO + clopidogrel (Clop) and MCAO + oleuropein (Ole). Results showed that the MCAO group evidenced significant brain edema (+ 9%) as well as increases of plasma cardiac markers such as lactate deshydrogenase (LDH), creatine kinase (CK-MB), fibrinogen and Trop-T by 11 %, 43%, 168 and 590%, respectively, as compared to the control group. Moreover, infarcted rats exhibited remarkable elevated level...
Source: Neurochemical Research - May 19, 2021 Category: Neuroscience Authors: Kais Mnafgui Lakhdar Ghazouani Raouf Hajji Abir Tlili Fatma Derbali Francisco Ivan da Silva Joabe Lima Ara újo Bianca de Oliveira Schinoff Jos é Fernando Ruggiero Bachega Ant ônia Laíres da Silva Santos Noureddine Allouche Source Type: research

Clopidogrel response in ischemic stroke patients: Is polymorphism or gender more important? Results of the CRISP study
Publication date: Available online 18 April 2020Source: Journal of Clinical NeuroscienceAuthor(s): Jitender Gairolla, Jasmina Ahluwalia, Madhu Khullar, Rupinder Kler, Kamal Kishore, Bikash Medhi, Manish Modi, Mukesh Kumar, Ashok Kumar, Dheeraj Khurana
Source: Journal of Clinical Neuroscience - April 19, 2020 Category: Neuroscience Source Type: research

Effect of alteplase versus aspirin plus clopidogrel in acute minor stroke
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Source: International Journal of Neuroscience - January 13, 2020 Category: Neuroscience Authors: Lihuan Lan Xiaoming Rong Qingyu Shen Hanxian Gong Xiangpen Li Hongxuan Wang Mei Li Jingrui Pan Xiaoni Zhang Ying Peng Source Type: research

Early Secondary Prevention in Transient Ischemic Attack (TIA) and Minor Stroke
AbstractPurpose of ReviewThe purpose of this study was to review recent literature on the early secondary prevention in transient ischemic attack (TIA) and minor stroke.Recent FindingsThe result of Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events and the secondary analysis of Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (POINT) have shown that treatment with clopidogrel and aspirin for 21  days reduced the risk of recurrent stroke with no significant increase in bleeding risk. Triple antiplatelet therapy with aspirin, clopidogrel, and dipyridamole resulted in a signific...
Source: Current Neurology and Neuroscience Reports - May 13, 2019 Category: Neuroscience Source Type: research

Antithrombotic Therapy.
Authors: Kwon SU, Kim JS Abstract Symptomatic cerebral atherosclerosis including intracranial atherosclerosis (ICAS) is associated with a high risk of recurrent stroke. Antithrombotic agents are the mainstay of therapy in these patients. Several studies have found anticoagulation (warfarin) to increase the risk of bleeding events and have an efficacy no better than that of aspirin. Therefore, anticoagulants are not widely used unless patients develop recurrent ischemic symptoms despite receiving antiplatelet therapy. Because ICAS progression is not uncommon and the risk of stroke recurrence is high when aspirin mon...
Source: Frontiers of Neurology and Neuroscience - December 15, 2016 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

A Case of Transient Global Amnesia: A Review and How It May Shed Further Insight into the Neurobiology of Delusions
Conclusion In closing, our patient’s episode of TGA combined with her emotional and perceptual response lends credence to the proposal of a “fear/paranoia” circuit in the genesis of paranoid delusions—a circuit incorporating amygdala, frontal, and parietal cortices. Here, neutral or irrelevant stimuli, thoughts, and percepts come to engender fear and anxiety, while dysfunction in frontoparietal circuitry engenders inappropriate social predictions and maladaptive inferences about the intentions of others.[54] Hippocampus relays information about contextual information based on past experiences and the current situat...
Source: Innovations in Clinical Neuroscience - April 1, 2016 Category: Neuroscience Authors: ICN Online Editor Tags: Anxiety Disorders Behavioral and Cognitive Neurology Case Report Cognition Current Issue Dementia Medical Issues Neurologic Systems and Symptoms Psychiatry Schizophrenia delusions hippocampus neurobiology Transient global amnesia Source Type: research

Antithrombotic therapy in transient ischemic attack patients.
Authors: Held VE, Wolf ME, Hennerici MG Abstract Historically, studies of antithrombotic therapy in ischemic cerebrovascular disease have included both stroke and transient ischemic attack (TIA). Thus, therapy regimes are very similar. Aspirin (75-325 mg within 48 h after onset of symptoms) is still the standard antithrombotic treatment because other agents have performed similarly (or worse). Combinations of agents have shown mixed results. Aspirin combined with clopidogrel has failed to show a significant reduction of stroke/TIA recurrences but increased the bleeding risk if taken for more than several months. Th...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Stroke subtypes and interventional studies for transient ischemic attack.
Authors: Lavallée P, Amarenco P Abstract Transient ischemic attack (TIA) is the most important risk factor for ischemic stroke. The risk is the highest in the first hours after symptom onset, and treatment must be initiated in emergency. In the acute phase, antithrombotic agent is probably the most important treatment, but it is not excluded that lipid-lowering agents and/or antihypertensive drugs are also important. For current guidelines, monotherapy of antiplatelet agent remains the gold standard in emergency. However, most recent data and meta-analysis support a combination therapy of clopidogrel and aspirin. ...
Source: Frontiers of Neurology and Neuroscience - December 2, 2015 Category: Neuroscience Tags: Front Neurol Neurosci Source Type: research

Influence of Genetic Polymorphisms on Clopidogrel Response and Clinical Outcomes in Patients with Acute Ischemic Stroke CYP2C19 Genotype on Clopidogrel Response.
CONCLUSIONS: CYP2C19*2 and CYP2C19*3 had a significant impact on clopidogrel response, but was not associated with ischemic events during 1 year of follow-up in patients with acute ischemic stroke. HPR was an independent risk factor for ischemic events, and the VerifyNow P2Y12 test may be available to guide individualized antiplatelet therapies in stroke patients in China. PMID: 26177117 [PubMed - as supplied by publisher]
Source: CNS Neuroscience and Therapeutics - July 15, 2015 Category: Neuroscience Authors: Han Y, Lv HH, Liu X, Dong Q, Yang XL, Li SX, Wu S, Jiang JM, Luo Z, Zhu DS, Zhang Y, Zheng Y, Guan YT, Xu JF Tags: CNS Neurosci Ther Source Type: research

Effect of omeprazole on the concentration of interleukin-6 and transforming growth factor-β1 in patients receiving dual antiplatelet therapy after percutaneous coronary intervention.
Authors: Hudzik B, Szkodzinski J, Danikiewicz A, Wilczek K, Romanowski W, Lekston A, Polonski L, Zubelewicz-Szkodzinska B Abstract BACKGROUND: Dual antiplatelet therapy (aspirin plus clopidogrel) is recommended in patients undergoing percutaneous coronary intervention (PCI). Treatment with proton pump inhibitors (PPIs) decreases bleeding rate. Alarming reports have been made that PPIs may decrease the antiplatelet activity of clopidogrel. We sought to determine whether levels of interleukin-6 (IL-6) and transforming growth factor-β1 (TGF-β1) might help distinguish individuals at risk for adverse events. METHO...
Source: European Cytokine Network - November 25, 2014 Category: Neuroscience Tags: Eur Cytokine Netw Source Type: research

Recurrent Stroke was Associated with Poor Quality of Life in Patients with Transient Ischemic Attack or Minor Stroke: Finding from the CHANCE Trial.
CONCLUSIONS: Stroke recurrence was associated with poor HRQOL in patients with TIA or minor strokes. Interventions focusing on controlling risk factors and prevention of worsening of neurological function may prevent poor HRQOL in these patients. PMID: 25307297 [PubMed - as supplied by publisher]
Source: CNS Neuroscience and Therapeutics - October 13, 2014 Category: Neuroscience Authors: Wang YL, Pan YS, Zhao XQ, Wang D, Johnston SC, Liu LP, Meng X, Wang AX, Wang CX, Wang YJ, The CHANCE investigators Tags: CNS Neurosci Ther Source Type: research

Neurovascular protection of cilostazol in stroke‐prone spontaneous hypertensive rats associated with angiogenesis and pericyte proliferation
This study sought to evaluate the effects of commonly used antiplatelet drugs on spontaneous cerebral infarction in relation to neurovascular protection associated with angiogenesis and pericyte proliferation. Stroke‐prone spontaneously hypertensive rats (SHR‐SP) were treated with vehicle, aspirin, clopidogrel, or cilostazol from 8 to 10 weeks of age. The interaction of neurovascular components among endothelial cells, pericytes, and astrocytic endfeet were immunohistochemically examined in brain sections. Angiogenesis associated with vascular endothelial growth factor receptor 2 (VEGFR2) and pericyte proliferation wer...
Source: Journal of Neuroscience Research - December 21, 2013 Category: Neuroscience Authors: Yoshio Omote, Kentaro Deguchi, Syoichiro Kono, Ning Liu, Wentao Liu, Tomoko Kurata, Toru Yamashita, Yoshio Ikeda, Koji Abe Tags: Research Article Source Type: research