title: Changes in platelet P-selectin and in plasma C-reactive protein in acute atherosclerotic ischemic stroke treated with a loading dose of clopidogrel.
abstract: BACKGROUND
  The surface expression of P-selectin on platelets contributes to the progression of inflammatory processes and thrombosis in atherothrombosis. In this study, we showed that the combination regimen of clopidogrel with aspirin could downregulate the P-selectin expression on platelets and the plasma concentration of C-reactive protein (CRP) in acute stage of atherosclerotic ischemic stroke.
  
  
  METHODS
  Patients with acute ischemic stroke (<24 hours) were randomized for 7 days to combined regimen of clopidogrel and aspirin (n = 24) or intravenous heparin with aspirin (n = 28). We measured the changes of National Institute of Health Stroke Scale (NIHSS) scores, CRP concentration, and surface expressions of P-selectin on platelets during 7 days.
  
  
  RESULTS
  The combined regimen of clopidogrel and aspirin significantly reduced platelet P-selectin expression (93.6 +/- 16.6, p < 0.01) and plasma concentration of CRP (1.2 +/- 1.5 mg/dl, p < 0.01) after 7 days of stroke onset compared with the values (P-selectin; 115.5 +/- 20.7, CRP; 2.5 +/- 2.8 mg/dl) of initial 24 hr. Also, the clinical improvement, as measured by NIHSS score, was significant in the clopidogrel loading group at 7 days (6.2 +/- 5.5, p < 0.05) compared to the initial 24 hrs (10.1 +/- 7.6).
  
  
  CONCLUSIONS
  Our results indicate that the combined regimen of clopidogrel and aspirin has beneficial effects on regulating platelet activation and inflammatory processes in acute atherosclerotic ischemic stroke. Thus, this combination regimen deserves further evaluation in clinical trial for the treatment of acute atherosclerotic ischemic stroke.
authors.affiliation: Department of Neurology, College of Medicine, Dong-A University, Korea. nrcjk@unitel.co.kr
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Cha
authors.forename: Min-Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Kyung-Mi
authors.initials: KM
authors.lastname: Lee
authors.forename: Hae-Rahn
authors.initials: HR
authors.lastname: Bae
authors.forename: Yeong-Jin
authors.initials: YJ
authors.lastname: Lim
authors.forename: Kyung Won
authors.initials: KW
authors.lastname: Park
authors.forename: Sang-Myung
authors.initials: SM
authors.lastname: Cheon
mesh_terms: D000368:Aged; D001161:Arteriosclerosis / Q000097:blood* / Q000188:drug therapy; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D001792:Blood Platelets / Q000187:drug effects* / Q000378:metabolism; D002545:Brain Ischemia / Q000097:blood* / Q000188:drug therapy; D002097:C-Reactive Protein / Q000378:metabolism*; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D020521:Stroke / Q000097:blood* / Q000188:drug therapy; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*
chemical_list: D019007:P-Selectin; D010975:Platelet Aggregation Inhibitors; D002097:C-Reactive Protein; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin