Evaluation of the Efficacy of Novel Biomarkers in Predicting Clopidogrel Resistance in Patients with Ischemic Stroke

Launched by NANJING FIRST HOSPITAL, NANJING MEDICAL UNIVERSITY · Dec 23, 2024

Keywords

ClinConnect Summary

This clinical trial is studying how certain biological markers in the blood can help predict whether patients with ischemic stroke (a type of stroke caused by a blood clot) are resistant to a medication called clopidogrel, which is commonly used to prevent further strokes. The researchers will collect blood samples from participants to analyze these markers and see how they relate to the effectiveness of clopidogrel in different patients. The goal is to better understand which markers can accurately indicate whether a patient might not respond well to this treatment.

To participate in the trial, individuals must be between 18 and 80 years old, have started standard antiplatelet therapy (which includes clopidogrel) within 72 hours after a mild stroke or high-risk transient ischemic attack (TIA), and meet certain health criteria. Participants can expect to provide blood samples at various times during their treatment and follow-up periods. It’s important to note that individuals with certain health conditions, recent severe strokes, or specific allergies will not be eligible for this study. This research aims to enhance our understanding of stroke prevention and improve treatment strategies for patients at risk.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Age range: 18-80 years old. Within 72 hours after symptom onset (admission), the patient has started receiving "standard" antiplatelet therapy (which must include Plavix, taken alone or in combination)
• • Diagnosed with mild, non cardiogenic, non disabling AIS (NIHSS score ≤ 3) or high-risk TIA (ABCD2 stroke risk assessment ≥ 4) based on the patient's symptoms, signs (such as hemiplegia, hemianopia, hemiparesis, aphasia, etc.) and various routine diagnoses and tests (including but not limited to neuroimaging, such as cranial CT, MRI, Doppler, etc.)
• Exclusion Criteria:
• • 72 hours after the onset of symptoms (admission), the patient began receiving "standard" antiplatelet therapy (including polivix, taken alone or in combination) for moderate or severe AIS (NIHSS score ≥ 5)
• • Patients who require intravenous thrombolysis (using rt PA, urokinase, alteplase, or tiniprase, etc.)
• • Mechanical intervention for thrombectomy
• • Cardiogenic AIS (with concomitant atrial fibrillation)
• • Embolic stroke of unknown origin (ESUS)
• • Perioperative stroke
• • Use anticoagulant drugs (such as warfarin, rivaroxaban, dabigatran etexils, etc.)
• • Individuals with severe liver and kidney dysfunction
• • Individuals allergic to clopidogrel or aspirin
• • Individuals with a tendency towards bleeding (such as low platelet count or active gastric or intestinal ulcers)
• • Individuals with a history of easy miscarriage or who are currently pregnant
• • Patients with malignant tumors or life expectancy of less than 1 year