Accumetrics-based clopidogrel dosing in endovascular neurosurgery

Neurological Research
Paul WongAli Alaraj

Abstract

The role of the VerifyNow test to guide clopidogrel therapy in neurosurgical patients is still unclear. This study compared outcomes in patients undergoing neurointerventional procedures on either standard clopidogrel or tailored clopidogrel regimens. Adult patients undergoing neurointerventional procedures from 1 May 2002 to 31 December 2012 at the University of Illinois Hospital and Health Sciences System were included if they were receiving dual antiplatelet therapy (DAPT) for their procedure. Patients were categorised based on the use of VerifyNow to guide therapy. The primary endpoint was the incidence of thromboembolic complications within 6 months post procedure. Secondary endpoints included the incidence of haemorrhagic complications and death. P2Y12 reaction units (PRU) were recorded when available and categorised based on relation to procedures and/or events. A total of 228 patients were screened with 130 meeting inclusion criteria. Ninety patients were grouped into the standard therapy arm and 30 patients into the tailored therapy arm. There were no differences in the incidence of ischaemic complications (1.1 vs 2.5%, P = 0.522), haemorrhagic complications (17.8 vs 15.0%, P = 0.455) or death (3.0 vs 0%, P = 0.552). S...Continue Reading

References

Jul 2, 2005·Neurosurgery Clinics of North America·David FiorellaPeter A Rasmussen
Jan 18, 2011·International Journal of Cardiology·Hasan AriTahsin Bozat
Mar 17, 2011·JAMA : the Journal of the American Medical Association·Matthew J PriceUNKNOWN GRAVITAS Investigators
Mar 1, 2010·Journal of Neurointerventional Surgery·David Fiorella
Jan 1, 2013·AJNR. American Journal of Neuroradiology·C GohB Yan
Sep 27, 2013·European Heart Journal·Dániel AradiUNKNOWN Working Group on Thrombosis of the European Society of Cardiology
Oct 1, 2013·Journal of the American College of Cardiology·Udaya S TantryUNKNOWN Working Group on On-Treatment Platelet Reactivity

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