Cerebrovascular Disease
Conditions
Keywords
antithrombotic therapy
Brief summary
To investigate the therapeutic effect of individualized treatment of antiplatelet in secondary prevention of ischemic stroke.
Detailed description
Ischemic stroke is a leading cause of disability and death worldwide. Antiplatelet treatment is one of treatment strategies in secondary stroke prevention for patients with non-cardioemoblism etiology. However, a concerning issue is that wide interindividual variability in P2Y12 antagonist, especially clopidogrel. The rate on-treatment high platelet reactivity (HPR) can be as high as in one-third of patients with standard dose of clopidogrel( i.e. 75mg), and HPR has been noted in those who received other P2Y12 antagonists, such as ticagrelor and prasugrel. In the present study, we aimed to investigate the safety and potential therapeutic effect of individualized treatment of antiplatelet in secondary prevention in a cohort of patients with non-cardioembolic ischemic strokes.
Interventions
DRUGDesirable TEG
Change the type and dose of antithrombotic therapy and obtain desirable TEG results. Antithrombotic drugs inclued Bayaspirin®，Plavix ® and Cilostazol.
DRUGUndesirable TEG
Don't change the type and dose of antithrombotic therapy and obtain undesirable TEG results. Antithrombotic drugs inclued Bayaspirin®，Plavix ® and Cilostazol.
Sponsors
Chinese PLA General Hospital
Peking University People's Hospital
Xuanwu Hospital, Beijing
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
14 Years to 80 Years
Healthy volunteers
Yes
Inclusion criteria
* 14 years of age or older * no gender aspirin or clopidogrel for ischemic cerebrovascular disease Primary or secondary prevention of ischemic stroke patients * The researcher (or principal) signs the informed consent form
Exclusion criteria
* Significant head trauma or stroke in the last 3 months * 3 months to accept intracranial, spinal surgery or other parts of large surgery * In the last week there is an incurable part of the artery puncture * Acute bleeding constitution, including platelet count \<100 × 109 / L or other conditions * within the last 48h heparin treatment, APTT higher than the upper limit of normal range * Oral anticoagulant: INR\> 1.7 or PT\> 15s * The presence of intracranial tumors, aneurysms or arteriovenous malformations * Patients with any of the following cardioembolic-related illnesses are identified: rheumatic mitral or aortic stenosis, prosthetic heart valves, atrial fibrillation, atrial flutter, sick sinus syndrome, left atrial myxoma, Open foramen ovale, left ventricular mural thrombus or valvular vegetation, congestive heart failure, bacterial endocarditis, or any other cardiovascular disease not suitable for enrollment; (as determined by the investigator) * Severe liver and kidney dysfunction * Life expectancy is less than 1 year * Pregnant or lactating women * Participating in other clinical studies, or have participated in other clinical studies within the 3 months before enrolling, or have already participated in this research * Allergic or intolerant to aspirin or clopidogrel * There are stomach lesions, such as gastritis, gastric ulcer and so on * Do not want to follow-up or poor treatment compliance
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Efficient Aspirin | one year | The value of inhibition rate of Aspirin \> 50% |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Efficient Clopidogrel | one year | The value of adenosine diphosphate\> 30% |
Other
| Measure | Time frame | Description |
|---|---|---|
| Platelet aggregability | one year | The value of maximum extent of thrombosis around 31-47 mm |
Countries
China
Contacts
Primary ContactMoli Wang, 1
Backup ContactQian Zhang, 2
Outcome results
None listed