J Korean Neurol Assoc > Volume 21(2); 2003 > Article

Journal of the Korean Neurological Association 2003;21(2): 128-133.

"급성기 동맥경화성 뇌경색 환자에서 고용량의 클로피도그렐 투여에 의한 혈소판 활성화의 정도 및 임상적 예후의 변화"

김욱주 , 이경미 박경원 김상호 김재우 정민호 임영진 차재관

동아대학교 의과대학 신경과학교실,의과학 연구소

"Changes of Platelet Activation and Clinical Outcome in Acute Atherosclerotic Cerebral Infarction Treated with Clopidogrel Loading Dose (300 mg)"

Wook-Joo Kim

Department of Neurology, Institute of Medical Science*, College of Medicine, Dong-A University

Abstract

"Background : Platelet activation has an important role in progression of atherosclerotic vascular events. To know the beneficial effects of clopidogrel loading dose about changes of platelet activation and clinical outcome in acute stage of atherosclerotic infarction, we performed a prospective randominized study. Methods : Patients with large artery athero-sclerotic infarction were randomized to clopidogrel loading dose (n=24) or intravenous heparin with low dose aspirin (n=28) during 7 days. We measured the surface expression of CD63 on platelets and the platelet aggregability for 7 days. The National Institute of Health Stroke Scale (NIHSS) score was recorded at 24 hours, 72 hours, and 7 days after stroke. Three-month outcome was recorded by the modified Barthel index (BI). R e s u l t s : As compared with intra-venous heparin, the loading dose of clopidogrel was associated with significant reduction of the surface expression of CD63 on platelets, platelet aggregability, and NIHSS score. The clopidogrel loading dose-treated patients were more likely to have a very favorable outcome on BI index at 3 months. Conclusions : Our results showed that the clopidogrel loading dose has beneficial effects of clinical outcome of acute stage of large artery atherosclerotic infarction may be mediated by the platelet hyperactivity in these patients. Thus, this loading dose trial deserves further evaluation in clini-cal trial for treatment in large artery atherosclerotic infarction.Key Words : Platelet, Ischemic stroke, Atheroclerosis, CD63"