on May 20, 2004
Published online before print May 20, 2004, doi: 10.1161/01.STR.0000131658.80951.c3
| |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Submitted on January 30, 2004
From Division of Cardiology (H.-K.Y., M.-C.C.), Department of Neurology (J.S.L., Y.-F.K., M.-Y.L., Y.-Y.C., S.-L.L., W.-H.C.), Chang Gung Memorial Hospital, Kaohsiung; Department of Biological Sciences (S.-S.C., H.-W.C.), National Sun Yat-Sen University, Taiwan, Republic of China. * To whom correspondence should be addressed. E-mail: chenmien{at}ms76.hinet.net.
Background and Purpose--Enhanced platelet activity has previously been reported in the acute phase after ischemic stroke. We tested the hypothesis that activated platelets (expressed by CD62p) are substantially increased in the acute stage after a stroke and decrease thereafter, and that antiplatelet therapies can suppress CD62p expression. Methods--We serially examined platelet CD62p expression using flow cytometry after acute ischemic stroke in 87 consecutive patients. The CD62p expression was also evaluated in 20 healthy volunteers and 33 at-risk control subjects. Results--CD62p expression was significantly higher in the acute phase after ischemic stroke than in normal and at-risk control subjects (both P<0.0001). CD62p expression decreased to a significantly lower level on day 21, and to a substantially lower level on day 90. CD62p expression was not significantly suppressed by warfarin. However, CD62p expression was significantly suppressed by aspirin treatment (P=0.024) and more substantially suppressed by clopidogrel (P<0.0001) on day 90. Furthermore, only clopidogrel treatment (P=0.0016) was significantly independently associated with decreased CD62p expression on day 90. Conclusions--Platelet activation was significantly increased in acute ischemic stroke and substantially decreased thereafter. The lesser long-term pharmacodynamic potency of aspirin relative to clopidogrel raises the prospect of the need for more effective antiplatelet agents or a synergistic combination therapy for stroke prevention in the future.
Revised on March 16, 2004
Accepted on April 5, 2004
Serial Changes in Platelet Activation in Patients After Ischemic Stroke. Role of Pharmacodynamic Modulation
Hon-Kan Yip MD;
Key words: stroke, ischemic • platelet activation • antiplatelet therapy
This article has been cited by other articles:
 |
|
 |
|
  J. Smout, A. Dyker, M. Cleanthis, G. Ford, P. Kesteven, and G. Stansby Platelet Function Following Acute Cerebral Ischemia Angiology, June 1, 2009; 60(3): 362 - 369. [Abstract] [PDF]
|
|
|
|
 |
|
 D.-F. Dai, P. Thajeb, C.-F. Tu, F.-T. Chiang, C.-H. Chen, R.-B. Yang, and J.-J. Chen Plasma concentration of SCUBE1, a novel platelet protein, is elevated in patients with acute coronary syndrome and ischemic stroke. J. Am. Coll. Cardiol., June 3, 2008; 51(22): 2173 - 2180. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. -K. Yip, C. -H. Lu, C. -H. Yang, H. -W. Chang, W. -C. Hung, C. -I. Cheng, S. -M. Chen, and C. -J. Wu Levels and value of platelet activity in patients with severe internal carotid artery stenosis Neurology, March 28, 2006; 66(6): 804 - 808. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. LeGuyader, R. Watanabe, J. Berbe, A. Boumediene, M. Cogne, and M. Laskar Platelet activation after aortic prosthetic valve surgery Interactive CardioVascular and Thoracic Surgery, February 1, 2006; 5(1): 60 - 64. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Kriszbacher, M. Koppan, J. Bodis, H.-K. Yip, S.-S. Chen, and M.-C. Chen Aspirin for Stroke Prevention Taken in the Evening? * Response: Stroke, December 1, 2004; 35(12): 2760 - 2762. [Full Text] [PDF]
|
|