COMPARISON OF CLOPIDOGREL AND ACETOSAL IN THE PREVENTION OF RECCURENT ISCHEMIC STROKE AT DR. MOEWARDI REGIONAL GENERAL HOSPITAL

Authors

  • Anis Dwi Kristiyowati Department of Clinical Pharmacy, Faculty of Pharmacy, Universitas Indonesia, Kampus Baru UI, Depok 16424, Indonesia.
  • Retnosari Andrajati Department of Clinical Pharmacy, Faculty of Pharmacy, Universitas Indonesia, Kampus Baru UI, Depok 16424, Indonesia.
  • Anton Bahtiar Department of Pharmacology and Toxicology, Faculty of Pharmacy, Universitas Indonesia, Kampus Baru UI, Depok 16424, Indonesia.

DOI:

https://doi.org/10.22159/ajpcr.2017.v10i10.19893

Keywords:

Recurrent stroke, Clopidogrel, Medical record, Nil

Abstract

 

 Objective: This study was conducted to determine the effect of clopidogrel on the prevention of recurrent stroke.

Methods: This study used case–control study; data were taken from patient's medical record of DR. Moewardi Regional General Hospital in the period of January 2013 – February 2017. Case group is a recurrent stroke patient receiving an acetosal or clopidogrel. The control group is a nonrecurrent stroke patient who receives an acetosal or clopidogrel.

Results: During the period of study, the number of medical sample record data are 177 samples from the entire study subjects that met the inclusion and exclusion criteria, 50 medical records entered as subject of case study, 32 medical record samples was excluded because medical record data at the first stroke was gone (obselete), 35 medical record was excluded because medical record data at first stroke was not at of DR. Moewardi Regional General Hospital, 4 samples of medical records was excluded for using a combination of acetosal and clopidogrel, 55 samples of medical records as control subjects. Patients who use clopidogrel have a tendency to prevent recurrent stroke, but statistically not significantly different. This study shows that men tend to suffer more recurrent ischemic stroke (64.0%) than women. While in the control group of recurrent ischemic stroke of women (56.4%) more experienced the first stroke than men. Patients who had a stroke almost all had a history of hypertension (90.2%). Recurrent stroke patients in this study almost all had a history of hypertension. Bivariate analysis was showed that gender, history of diabetes mellitus (DM) and history of hypertension had an effect on recurrent stroke events. From the multivariate analysis, it was found that men had a risk of 2.328 for recurrent stroke (p=0.047), the history of DM had a risk of 3.975 times for recurrent stroke (p=0.016) and history of hypertension was 4.021 times for recurrent stroke (p=0.03)

Downloads

Download data is not yet available.

References

Gouya G, Arrich J, Wolzt M, Huber K, Verheugt FW, Gurbel PA, et al. Antiplatelet treatment for prevention of cerebrovascular events in patients with vascular diseases: A systematic review and meta-analysis. Stroke 2014;45:492-503.

Ministry of Health Republics of Indonesia. Basic Health Researh 2013. Jakarta: Kementerian Kesehatan Republik Indonesia; 2013.

Mozaffarian D, Benjamin EJ, Go AS, Arnett DK, Blaha MJ, Cushman M, et al. AHA Statistical Update heart disease and stroke statistics – 2016 update A report from the American Heart Association. Circulation 2015;132:e2-323.

Sun Y, Lee SH, Heng BH, Chin VS 5-year survival and rehospitalization due to stroke recurrence among patients with hemorrhagic or ischemic strokes in Singapore. BMC Neurol 2013;13:133.

Furie KL, Kasner SE, Adams RJ, Albers GW, Bush RL, Fagan SC, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: A guideline for healthcare professionals from the american heart association/american stroke association. Stroke 2011;42:227-76.

Joseph TD. Pharmacotherapy: A Pathophysiologyc Approach. 8th ed. In New York: McGraw Hill; 2011. p. 353-60.

Goldstein LB, Bushnell CD, Adams RJ, Appel LJ, Braun LT, Chaturvedi S, et al. Guidelines for the primary prevention of stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011;42:517-84.

Albers GW, Amarenco P. Combination therapy with clopidogrel and aspirin: Can the CURE results be extrapolated to cerebrovascula patients? Stroke 2001;32:2948-9.

Siswanto Y. Some Risk Factors Affecting Recurrent Stroke Occurrences: A Case Study at Kariadi Hospital Semarang. Diponegoro of University; 2005.

Hewitt J, Castilla Guerra L, Fernández-Moreno Mdel C, Sierra C. Diabetes and stroke prevention: A review. Stroke Res Treat 2012;2012:673187.

CAPRIE Steering Committee. A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet 1996;348:1329-39.

Moroney JT, Bagiella E, Paik MC, Sacco RL, Desmond DW. Risk factors for early recurrence after ischemic stroke: The role of stroke syndrome and subtype. Stroke 1998;29:2118-24.

Silva GS, Koroshetz WJ, González RG, Schwamm LH. Causes of ischemic stroke. In: Acute Ischemic Stroke Imaging and Intervention. Vol. 8. Brazil: Springer-Verlag Berlin Heidelberg; 2011. p. 25-42.

National Heart Foundation of Australia. Guideline for the diagnosis and management of hypertension in adults. In: Guideline for the Diagnosis and managemnet of Hypertension in Adults 2016. Melbourne: National Heart Foundation of Australia; 2016.

U.S Department of Health and Human Services. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment High Blood Pressure: Seventh. Boston: NIH Publication; 2004.

Dennison-Himmelfarb C, Handler J, Lackland DT. 2014 evidence-based guideline for the management of high blood pressure in adults report from the panel members appointed to the eighth Joint National Committee (JNC 8). Clin Rev 2014;1097:1-14.

Sacco RL, Diener HC, Yusuf S, Cotton D, Ounpuu S, Lawton WA, et al. Aspirin and extended-release dipyridamole versus clopidogrel for recurrent stroke. N Engl J Med 2008;359:1238-51.

Milionis HJ, Gerotziafas G, Kostapanos MS, Vemmou A, Zis P, Spengos K, et al. Clopidogrel vs. aspirin treatment on admission improves 5-year survival after a first-ever acute ischemic stroke. data from the Athens Stroke Outcome Project. Arch Med Res 2011;42:443-50.

Vyasa BM, Dave R, Daniel P, Anand I, Patel C. A view on combination antiplatelet agents in ischemic stroke. India J Clin Pract 2013;23(11):701-6.

Shiau Y, Hu C, Chiueh CC. Journal of experimental and clinical medicine preventive effectiveness of aspirin on recurrent stroke. J Exp Clin Med (Elsevier Taiwan LLC) 2012;4(4):203-8.

Clark MA, Finkel R, Rey JA, dan Whalen K. Pharmacology. 5th ed. Philadelphia: Lippincont Williams&Wilkins; 2012.

Bashir S, Poornima R. Pharmaocogenetic variations related to clopiodogrel resistance and its clinical implications: An issue which remains largely unaddressed. Asian J Pharm Clin Res 2016;9(5):12-4.

Setyopranoto I, Wibowo S, Tjandrawinata RR. Hemostasis profile and clinical outcome of acute ischemic stroke patients treated with oral lumbrokinase DLBS1033: A comparative study versus aspirin and clopidogrel. Asian J Pharm Clin Res 2016;9(1):186-92.

Burn J, Dennis M, Bamford J, Sandercock P, Wade D, Warlow C. Long-term risk of recurrent stroke after a first-ever stroke. The Oxfordshire Community Stroke Project. Stroke 1994;25:333-7.

Hankey GJ, Jamrozik K, Broadhurst RJ, Forbes S, Burvill PW, Anderson CS, et al. Long-term risk of first recurrent stroke in the Perth Community Stroke Study. Stroke 1998;29:2491-500.

Hillen T, Coshall C, Tilling K, Rudd AG, McGovern R, Wolfe CD; South London Stroke Register. Cause of stroke recurrence is multifactorial: Patterns, risk factors, and outcomes of stroke recurrence in the South London Stroke Register. Stroke 2003;34:1457-63.

Qureshi AI. Contemporary reviews in cardiovascular medicine acute hypertensive response in patients with stroke pathophysiology and management. Circulation 2008;118:176-87.

Zavoreo I. Hyperglycemia and stroke. Period Biol 2012;114(3):269-75.

Jørgensen H, Nakayama H, Raaschou HO, Olsen TS. Stroke in patients with diabetes. The Copenhagen Stroke Study. Stroke 1994;25:1977-84.

Spurthi T, Gowthami B, Khyathi D, Vinod G. Risk elements and drug utilization in stroke patients. Int J Pharm Pharm Sci 2016;8(10):8-10.

Vurumadla S, Rakshith VM, Venkateswarlu K. A study on symptoms, risk factors and prescribing pattern of drugs used in stroke. Int J Pharm Pharm Sci 2014;7(1):421-6.

Published

01-10-2017

How to Cite

Dwi Kristiyowati, A., R. Andrajati, and A. Bahtiar. “COMPARISON OF CLOPIDOGREL AND ACETOSAL IN THE PREVENTION OF RECCURENT ISCHEMIC STROKE AT DR. MOEWARDI REGIONAL GENERAL HOSPITAL”. Asian Journal of Pharmaceutical and Clinical Research, vol. 10, no. 10, Oct. 2017, pp. 145-50, doi:10.22159/ajpcr.2017.v10i10.19893.

Issue

Section

Original Article(s)

Most read articles by the same author(s)

1 2 > >>