Acute ischemic stroke
Conditions
Interventions
Aspirin and clopidogrel with early neurologic deterioration:Aspirin and clopidogrel
Aspirin and clopidogrel did not show early neurologic deterioration:Aspirin and clopidogrel
Sponsors
Department of Neurology, Dalian Municipal Central Hospital
Eligibility
Sex/Gender
All
Age
18 Years to 100 Years
Inclusion criteria
Inclusion criteria: 1. Age >= 18 years old; 2. No history of stroke or no obvious sequelae of previous stroke (mRS=0-1); 3. Patients with acute ischemic stroke or TIA who are in line with the 2018 China Guidelines for the Diagnosis and Treatment of Acute Ischemic Stroke and diagnosed by head MRI or CT examination; 4. Antiplatelet therapy (aspirin + clopidogrel) within 24 hours after the onset of symptoms in patients without thrombolysis; antiplatelet therapy (aspirin + clopidogrel) 24 hours after thrombolysis in patients with thrombolysis; 5. Stroke patients with progressive exacerbation within 7 days / NIHSS score increased by 3 points / NIHSS score on limb paralysis increased by 2 points; 6. CYP2C19 gene detection; aspirin gene detection; 7. Agree to participate in this study, and give informed consent to the collection and preservation of case data and the follow-up process.
Exclusion criteria
Exclusion criteria: 1. Coma or clinical assessment (such as NIHSS>25) and/or other suitable imaging confirmed as severe stroke/obvious mass effect with midline shift (large infarct size)/acute hypodense lesions or disappearance of cerebral sulci >1/3 of the blood supply range of MCA; 2. CT examination found high-density lesions (bleeding), known history of intracranial hemorrhage, history of amyloid vessels, or suspected intracranial hemorrhage (including subarachnoid hemorrhage); 3. A history of coagulation disorders, systemic bleeding, thrombocytopenia or neutropenia; 4. Heparin should be used within 48 hours of onset, and aPPT exceeds the upper limit of laboratory normal value/current oral anticoagulation therapy (such as warfarin), PT-INR>1.5/or there is a clear indication for anticoagulation (assuming the source of emboli) in the heart, such as atrial fibrillation, prosthetic heart valves with known or suspected endocarditis); 5. Platelet count 400mg/dl (22.2mmol/l); 13. Severe liver disease, including liver failure, cirrhosis, portal hypertension (esophageal varices), active hepatitis; 14. Severe renal dysfunction (creatinine exceeding 1.5 times the upper limit of the normal range); 15. Severe heart failure (NYHA class: III ~ IV); high risk of chronic arrhythmia (1st or 2nd-degree atrioventricular block caused by sinus node disease, bradycardia syncope without pacemaker); diagnosis or a suspected diagnosis of the acute coronary syndrome; bacterial endocarditis, pericarditis; 16. With drug-induced blood disease, low white blood cells (<2 x 10^9/L) or platelet count (<100 x 10^9/L), hematocrit (HCT) <30%; 17. Asthma; 18. acute pancreatitis; 19. Patients with severe comorbidities or active cancer with an expected life expectancy of less than 2 years; 20. Do not agree to participate in the research or are unable to understand and/or follow research procedures due to mental, cognitive or emotional impairments; 21. Participating in another clinical study using an experimental product within the past 30 days; currently receiving an experimental drug or device; 22. Those who are pregnant, are pregnant, or have reproductive potential but have not taken birth control measures or are breastfeeding. 23. Accept neuro interventional therapy.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Clopidogrel metabolizes genotypes;Platelet aggregation rate;Thromboelastogram;C-reactive protein or hypersensitive C-reactive protein; | — |
Countries
China
Contacts
Public ContactYi Liu
Dalian Municipal Central Hospital
Outcome results
None listed