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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
09:21

Optimized Management of Endovascular Treatment for Acute Ischemic Stroke

Published on: January 18, 2018

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Response to clopidogrel is associated with early neurological deterioration after acute ischemic stroke

Xingyang Yi1, Jing Lin2, Yanfen Wang1

  • 1Department of Neurology, People's Hospital of Deyang City, Deyang 618000, Sichuan, China.

Oncotarget
|May 8, 2018
PubMed

Insights

Clopidogrel resistance (CR) is common in acute ischemic stroke (IS) patients and increases the risk of early neurological deterioration (END). Dual antiplatelet therapy with clopidogrel plus aspirin may help prevent END.

Area of Science:

  • Cardiology
  • Neurology
  • Pharmacology

Background:

  • The relationship between clopidogrel response and early neurological deterioration (END) after acute ischemic stroke (IS) requires further clarification.
  • Understanding clopidogrel resistance (CR) is crucial for optimizing antiplatelet therapy in IS patients.

Purpose of the Study:

  • To evaluate the association between clopidogrel resistance (CR) and early neurological deterioration (END) in acute ischemic stroke (IS) patients.
  • To analyze the effectiveness of clopidogrel alone versus clopidogrel plus aspirin in preventing END.

Main Methods:

  • Prospective, two-center study involving 375 IS patients treated with clopidogrel alone or in combination with aspirin.
  • Platelet aggregation was measured using adenosine diphosphate (ADP)-induced aggregation to assess CR.
  • Primary endpoint was END within 10 days; secondary endpoints included recurrent ischemic events and mortality.

Main Results:

  • Clopidogrel resistance (CR) was observed in 40.8% of patients; 25.3% experienced END within 10 days.
  • Higher platelet aggregation on admission and lower inhibition post-treatment were associated with END.
  • Diabetes mellitus, CR, and dual antiplatelet therapy (clopidogrel plus aspirin) were independent predictors of END.

Conclusions:

  • Clopidogrel resistance (CR) and early neurological deterioration (END) are frequent occurrences in acute ischemic stroke (IS).
  • CR is significantly associated with an increased risk of END.
  • Combination therapy with clopidogrel and aspirin demonstrates superior platelet aggregation inhibition and may offer protection against END.
Abstract

Keywords:
clopidogrel resistanceearly neurological deteriorationischemic strokesroke recurrence

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