Update in Glycoprotein IIb/IIIa Receptor Antagonist Clopidogrel: Use in Cerebrovascular Accidents
DOI:
https://doi.org/10.12974/2309-6179.2019.06.01Keywords:
Clopidogrel, Cerebrovascular accidents, Treatment, Prevention.Abstract
Acute ischemic stroke is the most common manifestation of cerebrovascular disease, which ranks the first to make an adult become bedridden and/or out of productive life. Antiplatelet therapy has long been demonstrated to alleviate the risks of recurrent untoward events, especially in the setting of secondary prevention. In the last decade it has been proved that dual antiplatelet therapy (DAPT) appears to be more efficacious than monotherapy with aspirin.
Clopidogrel (CLP) -an irreversible inhibitor of the platelet P2Y12 adenosine diphosphate receptor- is licensed in adults for the prevention of atherothrombotic events in patients suffering from MI, ischemic stroke (from 7 days to 6 months) or peripheral arterial disease. The recommended dose is 75 mg as a single daily dose, taken with or without food.
This review is designed to encompass use of the agent comprehensively and delineates a frame in which clinicians can view as a guide in their routine clinical practice.
References
Lopez AD, Mathers CD, Ezzati M, et al. Global and regional burden of disease and risk factors, 2001: systematic analysis of population health data. Lancet 2006; 367: 1747-57. https://doi.org/10.1016/S0140-6736(06)68770-9
Rothwell PM, Giles MF, Chandratheva A, et al, for the Early use of Existing Preventive Strategies for Stroke (EXPRESS) study. Effect of urgent treatment of transient ischaemic attack and minor stroke on early recurrent stroke (EXPRESS study): a prospective population-based sequential comparison. Lancet 2007; 370: 1432-42. https://doi.org/10.1016/S0140-6736(07)61448-2
International Stroke Trial Collaborative Group. The International Stroke Trial (IST): a randomised trial of aspirin, subcutaneous heparin, both, or neither among 19 435 patients with acute ischaemic stroke. Lancet 1997; 349: 1569-81. https://doi.org/10.1016/S0140-6736(97)04011-7
Geeganage CM, Diener HC, Algra A, et al. Dual or mono antiplatelet therapy for patients with acute ischemic stroke or transient ischemic attack: systematic review and metaanalysis of randomized controlled trials. Stroke 2012; 43: 1058-66. https://doi.org/10.1161/STROKEAHA.111.637686
Scarborough P, Peto V, Bhatnagar P, Kaur A, Leal J, Luengo-Fernandez R, et al. Stroke statistics. Oxford: British Heart Foundation Health Promotion Research Group and Health Economics Research Centre; 2009.
Jones L, Griffin S, Palmer S, Main C, Orton V, Sculpher M, et al. Clinical effectiveness and cost-effectiveness of clopidogrel and modified-release dipyridamole in the secondary prevention of occlusive vascular events: a systematic review and economic evaluation. Health Technol Assess 2004; 8(38). https://doi.org/10.3310/hta8380
Verro P, Gorelick PB, Nguyen D. Aspirin plus dipyridamole versus aspirin for prevention of vascular events after stroke or TIA: a meta-analysis. Stroke 2008; 39: 1358-63. https://doi.org/10.1161/STROKEAHA.107.496281
De Schryver E, Algra A, Van Gijn J. Dipyridamole for preventing stroke and other vascular events in patients with vascular disease. Cochrane Database Syst Rev 2007; 4: CD006186. https://doi.org/10.1002/14651858.CD001820.pub3
Pop C, Matei C, Petris A. Anticoagulation in Acute Coronary Syndrome: Review of Major Therapeutic Advances. Am J Ther 2019; 26(2): e184-e197. https://doi.org/10.1097/MJT.0000000000000913
Wang XH, Tao L, Zhou ZH, Li XQ, Chen HS. Antiplatelet vs. R-tPA for acute mild ischemic stroke: A prospective, random, and open label multi-center study. Int J Stroke. 2019 Mar 25; :1747493019832998. https://doi.org/10.1177/1747493019832998
Lu H, Guan W, Zhou Y, Tang Z, Bao H. Cangrelor or Clopidogrel in Patients with Type 2 Diabetes Mellitus Undergoing Percutaneous Coronary Intervention: A Meta- Analysis of Randomized Controlled Trials. Diabetes Ther 2019 Mar 23; https://doi.org/10.1007/s13300-019-0593-7
Jackevicius CA, An J, Ko DT, et al. Submissions from the SPRINT Data Analysis Challenge on clinical risk prediction: a cross-sectional evaluation. BMJ Open 2019 Mar 23; 9(3): e025936.
Diener HC, Bogousslavsky J, Brass LM et al. Aspirin and clopidogrel compared with clopidogrel alone after recent ischaemic stroke or transient ischaemic attack in high-risk patients (MATCH): randomised, double-blind, placebocontrolled trial. Lancet 2004; 364: 331-7. https://doi.org/10.1016/S0140-6736(04)16721-4
Bhatt DL, Fox KA, Hacke W et al. Clo¬pidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med 2006; 354: 1706-17. https://doi.org/10.1056/NEJMoa060989
Benavente OR, Hart RG, McClure LA et al. Effects of clopidogrel added to aspirin in patients with recent lacunar stroke. N Engl J Med. 2012; 367:817-25. https://doi.org/10.1056/NEJMoa1204133
Wang Y, Wang Y, Zhao X et al. Clopidogrel with aspirin in acute minor stroke or tran¬sient ischemic attack. N Engl J Med 2013; 369: 11-9. https://doi.org/10.1056/NEJMoa1215340
Pan Y, Jing J, Chen WQ, et al. Risks and benefits of clopidogrel-aspirin in minor stroke or TIA: time course analysis of CHANCE. Neurology 2017; 88: 1906-1911. https://doi.org/10.1212/WNL.0000000000003941
Johnston SC, Easton JD, Farrant M, et al. Clopidogrel and aspirin in acute ischemic stroke and high-risk TIA. N Engl J Med 2018; 379: 215-225. https://doi.org/10.1056/NEJMoa1800410
Toyoda K, Uchiyama S, Yamaguchi T, et al. CSPS.com Trial Investigators. Dual antiplatelet therapy using cilostazol for secondary prevention in patients with high-risk ischaemic stroke in Japan: a multicentre, open-label, randomised controlled trial. Lancet Neurol. 2019 Jun; 18(6): 539-548. https://doi.org/10.1016/S1474-4422(19)30148-6
Niu PP, Guo ZN, Jin H, Xing YQ, Yang Y. Antiplatelet regimens in the long-term secondary prevention of transient ischaemic attack and ischaemic stroke: an updated network meta-analysis. BMJ Open. 2016 Mar 17; 6(3): e009013. https://doi.org/10.1136/bmjopen-2015-009013
Karnon J, Brennan A, Pandor A, et al. Modelling the long term cost effectiveness of clopidogrel for the secondary prevention of occlusive vascular events in the UK. Curr Med Res Opin 2005; 21(1): 101-12. https://doi.org/10.1185/030079904X18036
De Santis M, De Luca C, Mappa I, et al. Clopidogrel treatment during pregnancy: a case report and a review of literature. Intern Med. 2011; 50(16): 1769-73. https://doi.org/10.2169/internalmedicine.50.5294
Reilly CR, Cuesta-Fernandez A, Kayaleh OR. Successful gestation and delivery using clopidogrel for secondary stroke prophylaxis: a case report and literature review. Arch Gynecol Obstet 2014; 290(3): 591-4. https://doi.org/10.1007/s00404-014-3269-6
Yilmaz S, Sahinkus S, Kilic H, Gunduz H, Akdemir R. Acute Coronary Syndrome During Pregnancy: A Case Report and Literature Review. Turk J Emerg Med 2016; 14(3): 135-8. https://doi.org/10.5505/1304.7361.2014.05924
Holm M, Biancari F, Khodabandeh S, et al. Bleeding in Patients Treated with Ticagrelor or Clopidogrel Before Coronary Artery Bypass Grafting. Ann. Thorac. Surg 2019 Mar 19;
Baharoglu MI, Cordonnier C, Salman RAS, et al. Platelet Transfusion Versus Standard Care After Acute Stroke due to Spontaneous Cerebral Haemorrhage Associated with Antiplatelet Therapy (PATCH): A Randomised, Open-Label, Phase 3 Trial. Lancet 2016; 1-9. https://doi.org/10.1016/S0140-6736(16)30392-0
Orlando Regional Medical Center. Department of Surgical Education. Antiplatelet Agent Reversal in Adults with Traumatic Intracranial Hemorrhage. URL: http://www.surgicalcriticalcare.net/Guidelines/TBI%20Antiplt %20Reversal%20Guideline%202012.pdf.
Bath PM, Woodhouse LJ, Appleton JP, et al; TARDIS Investigators. Antiplatelet therapy with aspirin, clopidogrel, and dipyridamole versus clopidogrel alone or aspirin and dipyridamole in patients with acute cerebral ischaemia (TARDIS): a randomised, open-label, phase 3 superiority trial. Lancet 2018; 391(10123): 850-859. https://doi.org/10.1016/S0140-6736(17)32849-0
Greenhalgh J, Bagust A, Boland A, Saborido C, Oyee J. Clopidogrel and modified-release dipyridamole for the prevention of occlusive vascular events (review of Technology Appraisal No. 90): a systematic review and economic analysis. Health Technol Assess 2011; 15(31). https://doi.org/10.3310/hta15310
Davis KA, Miyares MA, Dietrich E. Dual antiplatelet therapy with clopidogrel and aspirin after ischemic stroke: A review of the evidence. Am J Health Syst Pharm 2015; 72(19): 1623-9. https://doi.org/10.2146/ajhp140804
