LOAD: a pilot study of the safety of loading of aspirin and clopidogrel in acute ischemic stroke and transient ischemic attack

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
Dawn M MeyerJames C Grotta

Abstract

Most patients with ischemic stroke present to the emergency department beyond the approved 3-hour time window for thrombolytic or other revascularization therapies. Clopidogrel and aspirin loading is commonly used to prevent deterioration in other acute vascular occlusive events. This pilot study examined the safety of antiplatelet loading in acute ischemic stroke and transient ischemic attack. Forty patients with stroke or transient ischemic attack symptoms, not eligible for revascularization, received a single dose of 375 mg of clopidogrel and 325 mg of aspirin within 36 hours of stroke onset. All patients were admitted to a comprehensive stroke department and monitored for neurologic deterioration (2-point increase on National Institutes of Health stroke scale [NIHSS] score) and bleeding complications until hospital day 7 or discharge. NIHSS was performed at 24 hours postadmission and on hospital day 7 or discharge, whichever came first. A total of 40 patients were loaded with 375 mg of clopidogrel and 325 mg of aspirin (mean 12 hours 32 minutes). Mean admission NIHSS score was 6. There were no cases of systemic hemorrhage or mortality. A single symptomatic intracranial hemorrhage (2.5%) was detected 43 hours posttreatment. ...Continue Reading

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Citations

Oct 22, 2011·Journal of the Neurological Sciences·Tomomi NakamuraShinichiro Uchiyama
Dec 3, 2009·Critical Care Nursing Clinics of North America·Dawn Meyer
Nov 26, 2008·Neurologic Clinics·R Charles Callison, Harold P Adams
Aug 14, 2012·International Journal of Stroke : Official Journal of the International Stroke Society·Xin WangUNKNOWN CLAIR Study Investigators
Dec 14, 2011·Thrombosis and Haemostasis·Saskia H MevesHorst Neubauer
Mar 26, 2015·Annals of Emergency Medicine·Megan L FixJ Stephen Bohan
Jan 11, 2014·Thrombosis Research·Saskia H MevesHorst Neubauer
Jul 5, 2016·Frontiers in Neurology·Aleksandra YakhkindShadi Yaghi
Jul 9, 2016·Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association·Tse-Hsuan SuTsong-Hai Lee
Jul 28, 2016·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Min-Gyu ParkKyung-Pil Park
Nov 8, 2016·Stroke Research and Treatment·Amir ShabanSheryl Martin-Schild
Apr 22, 2011·Journal of Pharmacy Practice·Kathleen A Baldwin, Stacey L McCoy
Aug 29, 2013·Stroke; a Journal of Cerebral Circulation·Dawn M MeyerJustin A Zivin
Jan 11, 2019·Stroke; a Journal of Cerebral Circulation·Daniel G Hackam, J David Spence
Jun 25, 2018·Current Treatment Options in Neurology·Tarun GirotraBruce Ovbiagele

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