Abstract
Abstract W P59: Safety and Efficacy of Acute Clopidogrel Load in Patients with Moderate and Severe Ischemic Strokes
Stroke (1970), Vol.46(suppl_1)
02/2015
DOI: 10.1161/str.46.suppl_1.wp59
Abstract
Objective:
To study the safety and efficacy of clopidogrel loading in patients with moderate and severe strokes.
Background:
The safety of clopidogrel loading has been extensively investigated in patients with minor strokes and transient ischemic attacks.
Methods:
AIS patients presenting consecutively to our center from 06/07/07-07/31/13 were screened. Clopidogrel loading was defined as at least 300 mg dose (with or without aspirin) given within 6 hours of admission. We compared outcomes in patients with baseline NIHSS >3 with and without clopidogrel loading.
Results:
Inclusion criteria were met for 1011 patients (43.6% females, 69.1% black, median age 63). Patients with clopidogrel loading had lower baseline NIHSS than patients not loaded (8 vs 9, p=0.005). The two groups had similar risk of hemorrhagic transformation (p=0.918) and symptomatic hemorrhage (p=0.599). Patients who were loaded had a lower rate of neuroworsening (defined as an increase in NIHSS score by 2 points within 24 hours, 38.9% vs 48.3%, p=0.031) and less in-hospital mortality (4.3% vs 13.4%, p=0.001) compared to those who were not loaded. The likelihood of having a poor functional outcome (defined as mRS > 2 on discharge) did not differ between the two groups after adjusting for NIHSS on admission (OR=0.71, 95% CI 0.4633-1.0906, p=0.118).
Conclusion:
Clopidogrel loading dose is safe and was associated with reduced rates of neuroworsening and mortality following AIS in patients with more than minor stroke. A prospective study of safety and efficacy at preventing stroke progression more than minor strokes is warranted.
Details
- Title: Subtitle
- Abstract W P59: Safety and Efficacy of Acute Clopidogrel Load in Patients with Moderate and Severe Ischemic Strokes
- Creators
- Amir Shaban - Tulane UniversityNatalia Rincon - Tulane Univ Sch of Public Health and Tropical Medicine, New Orleans, LAJonathan Tiu - Dept of Neurology, Tulane Univ Sch of Medicine, New Orleans, LAMelisa Valmoria - Dept of Neurology, Tulane Univ Sch of Medicine, New Orleans, LADominique Monlezun - Dept of Neurology, Tulane Univ Sch of Medicine, New Orleans, LASheryl Martin-Schild - Stroke Program, Dept of Neurology, Tulane Univ Sch of Medicine, New Orleans, LA
- Resource Type
- Abstract
- Publication Details
- Stroke (1970), Vol.46(suppl_1)
- DOI
- 10.1161/str.46.suppl_1.wp59
- ISSN
- 0039-2499
- eISSN
- 1524-4628
- Language
- English
- Date published
- 02/2015
- Academic Unit
- Neurology
- Record Identifier
- 9984303440502771
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