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Platelet function in stroke/transient ischemic attack patients treated with tocotrienol.

Andrew Slivka1, Cameron Rink2, David Paoletto3

  • 1Department of Neurology, The Ohio State University Wexner Medical Center, Columbus, OH, USA.

FASEB Journal : Official Publication of the Federation of American Societies for Experimental Biology
|July 21, 2020
PubMed
Summary

Tocotrienol form of vitamin E (TCT) supplementation significantly reduced aspirin resistance in patients with stroke or transient ischemic attack (TIA) who were taking both aspirin and clopidogrel. This finding suggests TCT may improve antiplatelet therapy effectiveness.

Keywords:
aspirin resistanceclinical trialnutritionvitamin E

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Area of Science:

  • Cardiovascular Medicine
  • Neuroscience
  • Nutritional Science

Background:

  • Platelet aggregation plays a critical role in ischemic stroke and transient ischemic attack (TIA) pathogenesis.
  • Aspirin resistance and inadequate platelet inhibition are significant clinical challenges in patients with cerebrovascular events.
  • Tocotrienol (TCT), a form of vitamin E, possesses antioxidant and anti-inflammatory properties with potential antiplatelet effects.

Purpose of the Study:

  • To investigate the efficacy of tocotrienol (TCT) supplementation in modulating platelet function.
  • To assess the impact of TCT on aspirin resistance in patients with a history of ischemic stroke or TIA.

Main Methods:

  • A double-blind, randomized, placebo-controlled, single-center phase II clinical trial.
  • 150 patients with recent ischemic stroke or TIA received either placebo, 400 mg TCT, or 800 mg TCT daily for one year.
  • Platelet function was assessed using light transmission aggregometry at baseline and quarterly intervals.

Main Results:

  • In patients treated with both aspirin and clopidogrel, TCT significantly reduced the incidence of aspirin resistance.
  • Aspirin resistance decreased from 40% in the placebo group to 9% in the 400 mg TCT group (P = .03).
  • The 800 mg TCT group showed a reduction in aspirin resistance to 25%.

Conclusions:

  • Tocotrienol (TCT) supplementation effectively decreases aspirin resistance in patients with stroke or TIA on dual antiplatelet therapy.
  • TCT may represent a novel therapeutic strategy to enhance the effectiveness of antiplatelet medications in cerebrovascular disease.
  • Further research is warranted to elucidate the precise mechanisms and long-term clinical benefits of TCT in this patient population.