| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Kohriyama, Tatsuo Mihara, Chie Yokoyama, Takakazu Torii, Tsuyoshi Yamada, Atsuo Takamatsu, Kazuhiro Ota, Taisei Noda, Kouichi Kataoka, Satoshi Ito, Hijiri Nomura, Eiichi Ohtsuki, Toshiho Aoki, Shiro Nezu, Tomohisa Takeda, Ikuko Mukai, Tomoya Hosomi, Naohisa Matsumoto, Masayasu |
| Spatial Coverage |
Japan |
| Description |
Country affiliation: Japan Author Affiliation: Kohriyama T ( Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.); Mihara C ( Department of Neurosurgery, Yokoyama Hospital, Kure, Japan.); Yokoyama T ( Department of Neurosurgery, Yokoyama Hospital, Kure, Japan.); Torii T ( Department of Neurology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan.); Yamada A ( Department of Neurology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Japan.); Takamatsu K ( Department of Neurology, Brain Attack Center Ota Memorial Hospital, Fukuyama, Japan.); Ota T ( Department of Neurology, Brain Attack Center Ota Memorial Hospital, Fukuyama, Japan.); Noda K ( Department of Neurology, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima, Japan.); Kataoka S ( Department of Neurology, Chugoku Rousai Hospital, Kure, Japan.); Ito H ( Department of Neurology, Mifukai Vihara Hananosato Hospital, Miyoshi, Japan.); Nomura E ( Department of Neurology, Suiseikai Kajikawa Hospital, Hiroshima, Japan.); Ohtsuki T ( Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.); Aoki S ( Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.); Nezu T ( Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.); Takeda I ( Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.); Mukai T ( Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.); Hosomi N ( Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan. Electronic address: nhosomi@hiroshima-u.ac.jp.); Matsumoto M ( Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.) |
| Abstract |
BACKGROUND: Clopidogrel is sometimes substituted for ticlopidine when cerebrovascular or cardiovascular patients develop hematologic abnormalities after ticlopidine treatment. However, the adverse event rate after the substitution to clopidogrel remains undetermined. Therefore, in this study, we aimed to define the risk of adverse events after substituting clopidogrel for ticlopidine without a washout period. METHODS: We prospectively enrolled patients older than 20 years who had a history of noncardioembolic strokes, including transient ischemic attacks, were treated with ticlopidine for at least 6 months. This study was conducted from August 26, 2008, when the first patient was enrolled, to January 16, 2012, the date of the last patient examination, at 8 active stroke centers in Hiroshima, Japan. We excluded patients who had severe disabilities, evidence of cardioembolic stroke, or history of a bleeding event. Each patient received clopidogrel (either 50 mg or 75 mg) once a day in place of ticlopidine without a washout period. Follow-up exams were scheduled within 12 months after the medication substitution. The primary end point of this study was adverse events of interest, including clinically significant reduced blood cell counts, hepatic dysfunction, bleeding, and other serious side effects. RESULTS: In this study, 110 patients were enrolled and analyzed in an intent-to-treat manner (modified intent to treat). Within the scheduled follow-up periods, 9 primary end point events were observed in separate patients. The primary end point events were observed at a rate of 8.4% per year (Kaplan-Meier method). At the time of enrolment, 16 patients met the exclusion criteria, of which 8 recovered from their abnormal hematologic results to the institutional normal limit after the substitution of ticlopidine for clopidogrel (57.4% per year). CONCLUSIONS: The adverse event rates after the substitution of ticlopidine for clopidogrel is similar to the adverse event rates of patients who were initially treated with clopidogrel. The substitution of clopidogrel for ticlopidine should be considered for patients who develop hematologic abnormalities from ticlopidine treatment. |
| File Format |
HTM / HTML |
| ISSN |
10523057 |
| Issue Number |
6 |
| Volume Number |
23 |
| e-ISSN |
15328511 |
| Journal |
Journal of Stroke and Cerebrovascular Diseases |
| Language |
English |
| Publisher |
Elsevier |
| Publisher Date |
2014-07-01 |
| Publisher Place |
United States |
| Access Restriction |
One Nation One Subscription (ONOS) |
| Subject Keyword |
Research Support, Non-u.s. Gov't Brain Ischemia Stroke Adverse Effects Prospective Studies Humans Japan Middle Aged Drug Therapy Male Treatment Outcome Fibrinolytic Agents Aged, 80 And Over Hemorrhage Chemically Induced Therapeutic Use Journal Article Ticlopidine Discipline Cardiology Female Aged Drug Substitution Analogs & Derivatives |
| Content Type |
Text |
| Resource Type |
Article |
| Subject |
Rehabilitation Neurology (clinical) Surgery Cardiology and Cardiovascular Medicine |
