Abstract
The specific action of omega-3 fatty acid ethyl esters (OFA) in preventing cerebrovascular disease remains unknown, but research has demonstrated multiple possible mechanisms. In addition to altering lipid profiles, OFA may inhibit platelet aggregation. Clopidogrel inhibits platelets via the P2Y12 receptor. OFA may alter clopidogrel-associated platelet-inhibition via a possible combined effect on P2Y12 inhibition. To determine if OFA affects clopidogrel associated P2Y12 platelet receptor inhibition by comparing the percentage of responders in patients with cerebrovascular disease who were taking clopidogrel with or without OFA. We retrospectively reviewed data from adult patients with cerebrovascular disease or cerebral aneurysms and taking clopidogrel, who were seen at a single hospital between March 2010 to September 2011. We included 438 subjects in the study. For the 67 subjects who received loading doses of both clopidogrel and OFA, 71.6% had a P2Y12 inhibition response more than 20%, which is considered a positive response. For the 55 subjects who received just clopidogrel load, 67.2% of subjects were responders. There were 70.4% responders in the 274 subjects who were taking 75 mg of clopidogrel alone at home, and 73.8% responders in the 42 subjects who were taking both clopidogrel and OFA at home. However, these percentage differences were not statistically significant. This study did not find additional P2Y12 platelet inhibition when patients were given OFA, either given as a loading dose or taking it daily.
Highlights
Several trials have confirmed that antiplatelet agents like aspirin, clopidogrel, and aspirin-dipyridamole do provide secondary stroke prevention.[1,2] the use of antiplatelet agents is a mainstay of stroke management.[3]
The use of other agents for secondary stroke prevention such as HMG-CoA inhibitors is considered a valid addition to a post-stroke prevention regime.[3,4]
Materials and Methods loading doses of both clopidogrel and omega-3 fatty acid ethyl esters (OFA), 71.6% had a P2Y12 inhibition response more than 20%, which is considered a positive response
Summary
Detailed medication list on record, 268 were on clopidogrel for cardiac reasons only, and 43 were taking proton pump inhibitor. The included subjects were taking clopidogrel for either. Stent placement in carotid or vertebral-basilar arteries (235, 53.7%). In the 122 patients who received loading doses of clopidogrel, 67 (54.9%) received both loading doses of clopidogrel and OFA, and 55 (45.1%) received only clopidogrel loading dose
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