Man-man XU, Yun XU. Recurrent Ischemic Stroke[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(3): 285-288. doi: 10.3969/j.issn.1674-9081.2018.03.018
Citation: Man-man XU, Yun XU. Recurrent Ischemic Stroke[J]. Medical Journal of Peking Union Medical College Hospital, 2018, 9(3): 285-288. doi: 10.3969/j.issn.1674-9081.2018.03.018

Recurrent Ischemic Stroke

doi: 10.3969/j.issn.1674-9081.2018.03.018
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  • Corresponding author: XU Yun Tel:025-68182212, E-mail: xuyun20042001@aliyun.com
  • Received Date: 2018-01-10
  • Publish Date: 2018-05-30
  • In some patients who have low or no response to antiplatelet drugs, cardiovascular and cerebrovascular events still happen with standard antiplatelet therapy. In this case report, a 63-year-old woman appeared repeated episodes of limb weakness, although she had taken antiplatelet drugs, i.e. aspirin and clopidogrel, for a long time. Every time, magnetic resonance imaging showed that she had a fresh cerebral infarction; and at the same time, platelet aggregation test, clotting test, and gene test indicated clopidogrel and aspirin resistance, which meant low or no response to antiplatelet therapy. We changed immediately to cilostazol and followed up for more than 1 year. This patient had no recurrence of cardiovascular and cerebrovascular events anymore.
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  • [1] Esenwa C, Gutierrez J. Secondary stroke prevention:challenges and solutions[J]. Vasc Health Risk Manag, 2015, 11:437-450. http://pubmedcentralcanada.ca/pmcc/articles/PMC4536764/
    [2] Lee PN, Thornton AJ, Forey BA, et al. Environmental Tobacco Smoke Exposure and Risk of Stroke in Never Smokers:An Updated Review with Meta-Analysis[J]. J Stroke Cerebrovascular Dis, 2017, 26:204-216. doi:  10.1016/j.jstrokecerebrovasdis.2016.09.011
    [3] SPSS3 Study Group, Benavente OR, Coffey CS, et al. Blood-pressure targets in patients with recent lacunar stroke:the SPS3 randomised trial[J]. Lancet, 2013, 382:507-515. doi:  10.1016/S0140-6736(13)60852-1
    [4] Lin MP, Ovbiagele B, Markovic D, et al. Association of Secondhand Smoke with Stroke Outcomes[J]. Stroke, 2016, 47:2828-2835. doi:  10.1161/STROKEAHA.116.014099
    [5] Fu J, Tang J, Yang J, et al. Adding computed tomography and transcranial Doppler findings to the ABCD2 score to predict long-term risk of stroke after transient ischaemic attack or minor stroke[J]. Eur J Neurol, 2015, 22:520-526. doi:  10.1111/ene.12606
    [6] Chadha DS, Sumana B, Karthikeyan G, et al. Prevalence of aspirin resistance in Asian-Indian patients with stable coronary artery disease[J]. Catheter Cardiovasc Interv, 2016, 88:E126-E131. doi:  10.1002/ccd.25420
    [7] Jia DM, Chen ZB, Zhang MJ, et al. CYP2C19 polymor-phisms and antiplatelet effects of clopidogrel in acute ischemic stroke in China[J]. Stroke, 2013, 44:1717-1719. doi:  10.1161/STROKEAHA.113.000823
    [8] Cattaneo M, Cerletti C, Harrison P, et al. Recommendations for the Standardization of Light Transmission Aggregometry:A Consensus of the Working Party from the Platelet Physiology Subcommittee of SSC/ISTH[J]. J Thromb Haemost, 2013, 11:1183-1189. doi:  10.1111/jth.12231
    [9] Chen HY, Chou P. PFA-100-measured aspirin resistance is the predominant risk factor for hospitalized cardiovascular events in aspirin-treated patients:A 5-year cohort study[J]. J Clin Pharm Ther, 2018, 43:249-255. doi:  10.1111/jcpt.12643
    [10] Quarterman C, Shaw M, Johnson I, et al. Intra- and inter-centre standardisation of thromboelastography (TEG®)[J]. Anaesthesia, 2014, 69:883-890. doi:  10.1111/anae.12748
    [11] Fu Z, Dong W, Shen M, et al. Relationship between hyporesponsiveness to clopidogrel measured by thrombelastography and in stent restenosis in patients undergoing percutaneous coronary intervention[J]. Clin Biochem, 2014, 47:197-202. doi:  10.1016/j.clinbiochem.2014.08.009
    [12] Lin YJ, Li JW, Zhang MJ, et al. The association between CYP2C19 genotype and of in-stent restenosis among patients with vertebral artery stent treatment[J]. CNS Neurosci Ther, 2014, 20:125-130. doi:  10.1111/cns.12173
    [13] Pan Y, Chen W, Xu Y, et al. Genetic Polymorphisms and Clopidogrel Efficacy for Acute Ischemic Stroke or Transient Ischemic Attack:A Systematic Review and Meta-Analysis[J]. Circulation, 2017, 135:21-33. doi:  10.1161/CIRCULATIONAHA.116.024913
    [14] Wang Y, Zhao X, Lin J, et al. Association Between CYP2C19 Loss-of-Function Allele Status and Efficacy of Clopidogrel for Risk Reduction Among Patients With Minor Stroke or Transient Ischemic Attack[J]. JAMA, 2016, 316:70-78. doi:  10.1001/jama.2016.8662
    [15] Anderson CD, Biffi A, Greenberg SM, et al. Personalized approaches to clopidogrel therapy:are we there yet?[J].Stroke, 2010, 41:2997-3002. doi:  10.1161/STROKEAHA.110.594069
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