Efficacy of Clopidogrel on Incidence of Silent Brain Infarction (ECISBI)
Silent Brain Infarction
About this trial
This is an interventional other trial for Silent Brain Infarction
Eligibility Criteria
Inclusion Criteria:
- diagnosis of ischemic stroke/TIA
- 96 hours from onset of symptoms
- initial MRI available,
- not receiving antiplatelet therapy at the time of admission
- medical decision by the treating physician that antiplatelet therapy is indicated for secondary prevention (decision independent of the study and based on individual clinical decision for each patient).
- baseline coated-platelet levels at 40%,
- willingness to participate in the study for 24 months
Exclusion Criteria:
- dementia (based on chart review or self/proxy report)
- > 96 hours from onset of symptoms
- initiation of anticoagulation or thrombolytics prior to phlebotomy
- intracranial hemorrhage or bleeding diatheses
- end-stage renal disease (ESRD)
- inability to tolerate consenting or phlebotomy
- prior adverse/allergic reactions to clopidogrel
- treating physician deemed a different antiplatelet dose or dual antiplatelet therapy as the only treatment choice
Sites / Locations
- Oklahoma City VA Medical Center, Oklahoma City, OKRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Experimental
Clopidogrel
Aspirin
After randomization, patients will receive clopidogrel mg daily for the duration of the study. The VA Research Pharmacy will dispense similar looking pills (using a "dummy pill") with Arm 2 to ensure the double-blind nature of the intervention. Clopidogrel is FDA approved for secondary prevention of stroke. Patients will be followed for 24 months with repeat brain MRI scans obtained at 24 months.
After randomization, patients will receive aspirin daily for the duration of the study. The VA Research Pharmacy will dispense similar looking pills (using a "dummy pill") with Arm 1 to ensure the double-blind nature of the intervention. Aspirin is FDA approved for secondary prevention of stroke. Patients will be followed for 24 months with repeat brain MRI scans obtained at 24 months.