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alliedacademies
Journal of Pharmacology and Therapeutic Research
Volume 1 Issue 1 Clinical Pharmacy 2017
Notes:
Page 39
December 07-09, 2017 | Rome, Italy
7th World Congress on
Clinical Pharmacy and Pharmacy Practice
Relative comparison of loading dose
Clopidogrel (300 mg) vs. conventional dose
(75 mg) in decreasing the complications of
acute ischemic stroke
Sara Niafar1, Samaneh Haghighi2 and Mohammadreza Gheini2
1Islamic Azad University, Iran
2Tehran University of Medical Sciences, Iran
Background & Aim: Stroke is one of the leading causes
of morbidity and mortality in the world. Patients surviving
acute ischemic stroke or transient ischemic attack (TIA)
are at an increased risk for subsequent stroke. Consistent
with this notion, Antiplatelet agents are the mainstay for
secondary prevention of non-cardio embolic stroke. A
number of studies have indicated that Clopidogrel inhibits
platelet aggregation in these patients, so that Clopidogrel
loading dose has been more effective than maintenance
dose in reducing the risk of subsequent stroke and vascular
events without increasing the risk of bleeding events in
patients which have already had an episode of stroke or
TIA. In this study, we aimed to evaluate the comparative
efficacy of Clopidogrel loading dose vs. standard dose in
decreasing the complications of acute ischemic stroke in
patients admitted to Sina Hospital.
Methods & Materials: In this double-blinded clinical
trial, 76 patients with ischemic stroke referring to Sina
hospital were assigned in two groups: The first group
received Aspirin 80 mg and Clopidogrel 75 mg plus 225
mg placebo at baseline, followed by Clopidogrel 75 mg
and Aspirin 80 mg daily for 30 days, whereas the second
group received Aspirin 80 mg and Clopidogrel 300 mg in
the first day, followed by Clopidogrel 75 mg and Aspirin 80
mg daily for 30 days. Two weeks later, improvement of the
patients was compared. All patients were monitored for
neurologic deterioration to detect symptomatic ICH within
7 days after stroke. Also, they were followed for any new
bleeding event and recurrent stroke within 1 month.
Results: In this study, 76 patients, including comprising
41 males (53.9%) and 35 women (46.05%), mean age
67.45±6.85 years were evaluated. The difference between
the two groups in terms of age, sex, and risk factor of
stroke was not statistically significant. Based on MRS and
Barthel scores, the level of improvement after 2 weeks was
remarkably higher than the group received loading dose
Clopidogrel compared to that of standard dose (P <0.05).
The correlation between NIHSS, MRS, and Barthel scores
with age, sex, and the risk factor of ischemia were not
statistically significant (P>0.05). Besides, the frequency of
symptomatic ICH or any bleeding event in the group taken
the loading dose Clopidogrel was not significantly higher
than those received standard dose (P=0.43)
Conclusion: Our data have shown that administration
of loading dose Clopidogrel after ischemic stroke (within
24 hours), not only augmented neurologic improvement
as well as daily activities in patients with acute ischemic
stroke, but also did not increase the risk of hemorrhagic
complications.
Sara Niafar et al., J Pharmacol Ther Res 2017