Efficacy and safety of modified antiplatelet preparation in patients with high on-treatment platelet reactivity after endovascular coiling for unruptured intracranial aneurysms

doi:10.3969/j.issn.1006-7795.2018.01.025

Abstract

Abstract: Objective To evaluate the efficacy and safety of modified antiplatelet preparation in patients with high on-treatment platelet reactivity(HTPR) after endovascular coiling for unruptured intracranial aneurysms(UIA).Methods In the randomized, parallel designed clinical trial, 166 patients colling for UIA with HTPR were assigned to receive either 100 mg of aspirin and 75 mg of clopidogrel bisulfate once daily for 3 months(n=83) or 300 mg of aspirin and 75 mg of clopidogrel bisulfate once daily, or 100 mg of aspirin and 75 mg of clopidogrel bisulfate once daily and cilostazol twice daily for 3 months(n=83). Platelet function was serially measured at various time points by 3 assessment methods. Adverse ischemia events(stroke and intravascular thrombosis) and bleeding events were evaluated.Results Patients with HTPR was fewer in modified group compared with standard group at various time points. The adverse ischemia events occurred in fewer patients in modified group than in standard group(8.4% vs 1.2%,HR=0.132,95% CI:0.016-1.101,P=0.030). There was no statistical difference in the rate of bleeding events between modified group and standard group.Conclusion Modified antiplatelet preparation for patients with HTPR compared with standard antiplatelet preparation reduced the adverse ischemia events rate in coiling for an unruptured aneurysm without increasing bleeding.

Key words: unruptured intracranial aneurysms (UIA), interventional therapy, high-dose, antiplatelet, efficacy, safety

CLC Number:

R739.41

Xia Pengfei, Wang Wei, Zou Liang, Ma Yingming. Efficacy and safety of modified antiplatelet preparation in patients with high on-treatment platelet reactivity after endovascular coiling for unruptured intracranial aneurysms[J]. Journal of Capital Medical University, 2018, 39(1): 143-147.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2018.01.025

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2018/V39/I1/143

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