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Abstract
Till now there’s no large sample, randomized and double-blinded research of clopidogrel in acute cerebral infarction. There have been some studies of combined and loading dosage of clopidogrel for antiplatelet treatment but the NIHSS is no more than 5 potints. Our study is to evaluate the efficacy and safety of clopidogrel in acute ischemic stroke. It’s a single center retrospective study. Collect information of patients with acute ischemic stroke from January 1st 2012 to May 31st 2015, using of different antiplatelet drugs, occuring of progressive ischemic stroke, risk factors of cardiovascular and cerebrovascular diseases, etiological classification of cerebral infarction, NIHSS scores on admission and 7 days after admission were collected and was calssified into different groups (NIHSS≤3, 4-7, 8-15 and ＞15 potints). correlation statistical analysis was performed with chi-square test. A total of 1008 patients were collected, 94 of them had progressive ischemic stroke. There was no significant difference between aspirin group and clopidogrel group (routine clopidogrel group and loading clopidogrel group) within 7 days of onset. Clopidogrel group was superior to aspirin in reducing early recurrence and deterioration within 24 hours while NIHSS on admission was greater than 3 points. PIS has close relation to admission time after onset and severity of clinc. There was no significant difference in the incidence of safety events between aspirin and clopidogrel (routine clopidogrel and loading clopidogrel). Loading dosage of clopidogrel is as safe as the routine group and aspirin group.
Highlights
Early time using of aspirin for antiplatelet therapy can reduce stroke recurrence, but the net benefit of aspirin is relatively low and is useless for progressive ischemic stroke [1, 2]
The aim is to evaluate whether clopidogrel is superior to aspirin and whether loading dosage of clopidogrel is superior to aspirin
Clopidogrel group was superior to aspirin in reducing early recurrence and deterioration within 24 hours, while NIHSS on admission was greater than 3 points and NIHSS score was 8-15
Summary
Early time using of aspirin for antiplatelet therapy can reduce stroke recurrence, but the net benefit of aspirin is relatively low and is useless for progressive ischemic stroke [1, 2]. A number of antiplatelet drug studies for patients with acute cerebral infarction such as CHANCE [4], SUMMPRIS [5], SOCRATES [6] and CLASS-CHINA [7] had shown exploration and bright prospect of combined and loading dosage of clopidogrel for antiplatelet treatment. In the research of SOCRATES [6], Most of the patients with middle cerebral infarction were mild stroke patients (NIHSS score ≤ 5 points), in which the CHANCE study [9] answered the TIA (ABCD2 score ≥ 4 points) and the minor stroke (NIHSS score ≤ 3 points), the superiority of combined and loading dosage of antiplatelet over aspirin alone. Our center start to use clopidogrel from 2005 and standard operating procedures (SOP) from 2012 require loading dosage of clopidogrel and combination with aspirin for 7 days in patients of NIHSS score of ≤ 7 points. The aim is to evaluate whether clopidogrel is superior to aspirin and whether loading dosage of clopidogrel is superior to aspirin
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