Key result
Aspirin and clopidogrel suppressed stimulated platelet P-selectin (mean difference for aspirin 360.3, P<0.001), though 24.7% of patients on clopidogrel had high on-treatment reactivity.
Why the study?
Does baseline use of aspirin or clopidogrel reduce platelet P-selectin expression in patients with acute stroke or TIA?
Population
Patients with acute stroke or transient ischaemic attack
Comparison
Aspirin or clopidogrel taken at baseline vs Patients not taking the respective antiplatelet…
Design
Cross-sectional
Authors
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Supports remote platelet testing feasibility in stroke trials; leaves open clopidogrel reactivity impact on outcomes.
RCT
Yes
Does baseline use of aspirin or clopidogrel reduce platelet P-selectin expression in patients with acute stroke or TIA?
Mean Difference: 360.3 (95% CI 312.2–408.4)
Absolute Event Rate: 210% vs 570%
p-value: p=<0.001
Remote platelet function testing is feasible in multicenter trials and demonstrates that while aspirin and clopidogrel suppress P-selectin, high on-treatment reactivity is common with clopidogrel.
Bath et al. (2017) conducted an RCT in Acute stroke or transient ischaemic attack. Antiplatelet agents (aspirin and clopidogrel) vs. Not taking the respective antiplatelet agent was evaluated on Platelet expression of P-selectin (aspirin test) (MD 360.3, 95% CI 312.2-408.4, p=<0.001). Aspirin and clopidogrel suppressed stimulated platelet P-selectin (mean difference for aspirin 360.3, P<0.001), though 24.7% of patients on clopidogrel had high on-treatment reactivity.
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