Role of microembolic signals in the evaluation of antithrombotic agent therapy: a preliminary study / 国际脑血管病杂志

ABSTRACT

Objective To preliminarily study on the values of microembolic signal(MES)monitoring in the evaluation of anti-Platelet agent or anti-Platelet agent+statins in patients with acute ischemic cerebrovascular disease.Methods Among the patients with acute ischemic cerebrovascular disease in the cm'otid system who performed MES monitoring the MES-positive patients were ramaomly allocated into dual antiplatelet group(aspirin 100 mg/d+clopidogrel 75 mg/d)and dual antiplatelet + atorvastatin goup (aspirin 100 mg/d + clopidogrel 75 mg/d +atorvastatin 20 me4d).MEss were monitored by transcranial Doppler ultrasound.Results Among the 60 patients with acute cerebrovascular disease in the carotid system,13(21.7%)were MES positive.in which,6 and 7 were randomly divided into dual antiplatelet group and dual antiplatelet + atorvastatin group respectively.There were no significant differences in the constituent ratios of sex hypertmsion,diabetes,coronary heart disease,smoking,alcohol consumption,and history of previous stroke as well as the age,time from onset to microembolic monitoring,and time from onset to drug intervention between the 2 groups.There were no significant differences in the numbers of microemboli(8.83±1.17/h vs.9.00±1.83/h)before treatment between the dual alltiplatelet group and dual antiplatdet + atorvastatin group (P=0.851);2 and 7 days after treatment,the numbers of micromixfli were 4.17±1.47 and 2.17±0.75/h respevtively in the dutral antiplatelet group,and they were significantly higher than 1.43±0.976 and 0.71±0.488/h)respevtively in the dual antiplatelet + atorvastatin group (P=0.002 and P=0.003).They were followed up for 8 days;and there were 110 ischemic events in both groups.Conclusions The dual antiplatelet agents or those in combination with statins might reduce the number of MES,but when they were used in combination with statins,the number Of MES reduced more significant.However.because there are only a few patients in the study,this conclusion still needs to be further validatod in a large-scale multicenter randomized controlled trial.The MES monitoring has a certain value in the evaluation of anti-platelet drugs or those in combination with statins