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Secondary Stroke Prophylaxis with Clopidogrel Produces Sufficient Antiplatelet Response

Charlotte Lützhøft Rath1, Niklas Rye Jørgensen2, Troels Wienecke3

  • 1Neurovascular Centre, Dept. of Neurology, Zealand University Hospital, Denmark.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|June 28, 2018
PubMed

Insights

High on-treatment platelet reactivity (HTPR) to clopidogrel was uncommon in Danish ischemic stroke patients. This study found no significant link between clopidogrel HTPR and recurrent ischemic events, suggesting it

Area of Science:

  • Cardiology
  • Neurology
  • Pharmacology

Background:

  • Antiplatelet therapy is crucial for preventing secondary ischemic stroke (IS) and transient ischemic attack (TIA).
  • A subset of patients on antiplatelet therapy experience recurrent cerebrovascular events.
  • High on-treatment platelet reactivity (HTPR) to clopidogrel has been linked to increased recurrent stroke risk.

Purpose of the Study:

  • To investigate the association between clopidogrel HTPR and recurrent ischemic events in Danish IS patients.
  • To determine if clopidogrel HTPR is a significant risk factor for secondary ischemic events.

Main Methods:

  • Prospective observational study design.
  • Inclusion of 142 Danish IS patients.
  • Assessment of HTPR (platelet reaction units >208) and a 2-year composite endpoint of recurrent stroke, TIA, acute myocardial infarction (AMI), or vascular death.

Main Results:

  • Only 2.1% of patients (3 out of 142) exhibited clopidogrel HTPR.
  • The incidence of recurrent ischemic events was 10% (14 patients).
  • No statistically significant difference in recurrent events was observed between HTPR and non-HTPR groups due to the small number of HTPR patients.

Conclusions:

  • Clopidogrel HTPR appears to be infrequent in this Danish IS cohort.
  • The study suggests clopidogrel HTPR is not a major driver of recurrent ischemic events in this population.
Abstract

Keywords:
Antiplatelet therapycerebrovascular diseaseclopidogrelhigh on-treatment platelet reactivitystroke

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