Use of Clopidogrel in Ischemic Stroke Patients

Abstract

Stroke is a clinical condition that develops rapidly and is caused by focal (diffused) brain injuries or damage accompanied by symptoms that can occur for 24 hours, and it can lead to death. Clopidogrel is an antiplatelet drug used to prevent stroke by reducing the ability of blood to clot. This study aimed to examine the usage pattern of clopidogrel in ischemic stroke patients at Sidoarjo Public Hospital during the period of January – December 2020. This study was observational and retrospective. The data were analyzed descriptively. Monotherapy of clopidogrel was registered in all patients (100%) with a dosage of 1 x 75 mg delivered orally. The use of clopidogrel with other antiplatelet drugs was 1 x 80 mg ASA delivered orally and 1 x 75 mg clopidogrel given orally for 1 patient.


Keywords: clopidogrel, antiplatelet, ischemic stroke

References
[1] World Health Organization. Stroke, cerebrovascular accidents. WHO; n.d.


[2] American Stroke Association. Stroke risk factors you can control, treat and improve. American Stroke Association; n.d.


[3] Indonesian Ministry of Health. Riskesdas 2018 report. National Riskesdas Report. 2018;53(9):181–222.


[4] Wells B, Schwinghammer T, DiPiro J, Dipiro C. Pharmacotherapy handbook. New York, NY: McGraw-Hill Companies; 2017.


[5] Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the early management of patients with acute ischemic stroke: 2019 update to the 2018 guidelines for the early management of acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke. Stroke. 2019;50(12):E344–E418.


[6] Dipiro JT, Yee GC, Posey M, Haines ST, Nolin TD, Ellingrod V. Pharmacotherapy: A pathophysiologic approach. 11th ed. New York, NY: McGraw Hill Medical; 2020.


[7] EMC. Clopidogrel 75 mg film-coated Tablets.


[8] Hackam DG, Spence JD. Antiplatelet therapy in ischemic stroke and transient ischemic attack: An overview of major trials and meta-analyses. Stroke. 2019;50(3):773–778.


[9] BNF. British national formulary. 74th ed. UK: BMJ Group and The Royal Pharmaceutical Society.


[10] Norrving B. Oxford textbook of stroke and cerebrovascular disease. Oxford: Oxford University Press; 2014.


[11] Yousufuddin M, Young N. Aging and ischemic stroke. Aging. 2019;11(9):2542–2544.


[12] Fekadu G, Chelkeba L, Kebede A. Risk factors, clinical presentations and predictors of stroke among adult patients admitted to stroke unit of Jimma University Medical Center, southwest Ethiopia: Prospective observational study. BMC Neurology. 2019;19(1):187.


[13] Stroke Foundation. Ischemic stroke.


[14] A/L Rajendram A, Husen IR, Basuki A. Antiplatelet drugs and its gastrointestinal side effects among ischemic stroke patients in Dr. Hasan Sadikin General Hospital 2011. Althea Medical Journal. 2015;2(1):15–19.


[15] Paciaroni M, Ince B, Hu B, et al. Benefits and risks of clopidogrel vs. aspirin monotherapy after recent ischemic stroke: A systematic review and meta-analysis. Cardiovascular Therapeutics. 2019;2019:1–13.


[16] Koziol K, Van der Merwe V, Yakiwchuk E, Kosar L. Dual antiplatelet therapy for secondary stroke prevention: Use of clopidogrel and acetylsalicylic acid after noncardioembolic ischemic stroke. Canadian Family Physician Le Médecin de Famille Canadien. 2016;62:640–645.


[17] Kikkert WJ, Damman P. Optimal duration of dual antiplatelet therapy for coronary artery disease. Netherlands Heart Journal. 2019;26(6):321–333.


[18] Park CG. Is amlodipine more cardioprotective than other antihypertensive drug classes? Korean Journal of Internal Medicine. 2014;29:301–304.


[19] Göz E, Kahraman T, Genc A, Kutluk K. Factors affecting hospital length of stay amon patients with acute stroke. Journal of Neurological Sciences. 2017;34(2):143–152.