London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 743 Table 1: Patient characteristics and event frequencies Parameter No anticoagulant (n=96) Parenteral anticoagu-lant (n=48) Warfarin (n=76) Dabigatran (n=7) Total (n=189) Mean Age 78.7 77.9 80.4 72.6 79.0 Female Sex 54 (56%) 27 (56%) 47 (62%) 3 (43%) 109 (58%) Mean INR at Presentation 1.2 1.3 1.4 1.3 1.3 Recurrent Stroke/TIA 4 (4.2%) 1 (2.1%) 2 (2.6%) 1 (14%) 9 (4.8%) Symptomatic Hemorrhage 10 (10%) 6 (12%) 4 (5.3%) 0 (0%) 16 (8.5%) Intracranial Hemorrhage 5 0 0 0 5 Gastrointestinal Hemorrhage 1 1 0 0 2 Genitourinary Hemorrhage 2 1 1 0 3 Retroperitoneal Hematoma 0 1 0 0 1 Limb Hematoma 1 2 2 0 3 Other 1 2 1 0 3 753 Stroke prevention Clopidogrel resistance in cerebrovascular patients - 1 year follow-up G. Feher1, L. Szapary2 William Harvey Hospital, Ashford, UNITED KINGDOM1, Department of Neurology, University of Pecs, Pecs, HUNGARY2 INTRODUCTION – Platelets have a central role in the development of arterial thrombosis and sub-sequent cardiovascular events. An appreciation of this has made antiplatelet therapy the cornerstone of cardiovascular disease management. Recent studies have described the phenomenon of clopido-grel resistance but relatively few articles focsed on cerebrovascular patient populations. PATIENTS AND METHODS – 100 patients with a history of acute stroke or transient ischaemic at-tack were involved in our study. The efficiency of the therapy was assessed on day 7, 28, month 3,6 and 12 of medical therapy. Patients were divided into two parts (clopidogrel responder and resistant) based on their initial laboratory findings. Risk profiles, medical therapy, laboratory parameters and vascular events were compared between the two patient groups. RESULTS – At the first measurement (day 7) after clopidrogel-hydrogen sulphate treatment, the therapy seemed to be inefficient in 11 patients (11%). A strong, clinically significant correlation was found between blood pressure values, blood glucose and lipid parameters, hsCRP levels and platelet aggregation values. At the next measurements, an aggressive secondary preventive threapy resulted in the normalisation of the above mentioned parameters, and the efficiency of platelet aggregation inhibtion therapy was also improed, whereas no patients proved to be resistant. Initial clopidogrel resistant patients had a significiantly higer rate of vascular events (18,1 vs. 4,5 %, , p < 0,01) com-pared to responder ones, although resistance seemed not to be an independent risk factor of unfa-vourable vascular outcome in a multivariate analysis. No unwanted events or haemorrhagic compli-cations were registered. CONCLUSIONS – On the basis of the result of our study, treatment with clopidogrel- hydrogen sul-phate is safe and efficient both clinically and on the basis of optical aggregometry. The significance of an aggressive secondary preventive therapy should be considered as a factor that might influence the efficiency of thrombocyte aggregation inhibitory therapy.
Karger_ESC London_2013
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