Clopidogrel may decrease the risk of post‐stroke infection after ischaemic stroke

Kim, T. J.; Lee, J. S.; Kang, Min Kyoung; Nam, Ki‐Woong; Lee, C.‐H.; Mo, Heejung; Jeong, Han‐Yeong; Yoon, Byung Woo; Ko, Sang‐Bae

doi:10.1111/ene.13801

Cited by 8 publications

(3 citation statements)

References 40 publications

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“…However, additional studies are required to establish a clearer understanding of the relationship. There is evidence suggesting that aspirin and clopidogrel may have a protective effect against infection [ 59 , 60 ], leading to the hypothesis that anticoagulants may have similar protective effects. Additionally, it is important to further examine the impact of drugs that control ventricular rate in atrial fibrillation, such as beta-blockers or calcium channel blockers, on post-stroke infection.…”

Section: Discussionmentioning

confidence: 99%

“…To determine the risk factors for post-stroke infections, the following clinical characteristics were extracted from the CDW: age at diagnosis, sex, comorbidities (Charlson comorbidity index (CCI)), hypertension, and atrial fibrillation), and exposure to medications including steroids, acid-suppressant drugs (proton pump inhibitors and H2 blockers), opioids, benzodiazepines, anticholinergics, dopamine agonists, selective serotonin reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs), aspirin, and clopidogrel, known to be related to stroke infection [ 35 , 36 , 43 , 60 ].…”

Section: Methodsmentioning

confidence: 99%

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Post-Stroke Infections: Insights from Big Data Using Clinical Data Warehouse (CDW)

Jung

Park

et al. 2023

Antibiotics

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This study analyzed a digitized database of electronic medical records (EMRs) to identify risk factors for post-stroke infections. The sample included 41,236 patients hospitalized with a first stroke diagnosis (ICD-10 codes I60, I61, I63, and I64) between January 2011 and December 2020. Logistic regression analysis was performed to examine the effect of clinical variables on post-stroke infection. Multivariable analysis revealed that post-stroke infection was associated with the male sex (odds ratio [OR]: 1.79; 95% confidence interval [CI]: 1.49–2.15), brain surgery (OR: 7.89; 95% CI: 6.27–9.92), mechanical ventilation (OR: 18.26; 95% CI: 8.49–44.32), enteral tube feeding (OR: 3.65; 95% CI: 2.98–4.47), and functional activity level (modified Barthel index: OR: 0.98; 95% CI: 0.98–0.98). In addition, exposure to steroids (OR: 2.22; 95% CI: 1.60–3.06) and acid-suppressant drugs (OR: 1.44; 95% CI: 1.15–1.81) increased the risk of infection. On the basis of the findings from this multicenter study, it is crucial to carefully evaluate the balance between the potential benefits of acid-suppressant drugs or corticosteroids and the increased risk of infection in patients at high risk for post-stroke infection.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Post-Stroke Infections: Insights from Big Data Using Clinical Data Warehouse (CDW)

Jung

Park

et al. 2023

Antibiotics

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“…Infectious complication was defined as any infection events, including pneumonia, urinary tract infection, and other infections for three days after admission. [18–20] Laboratory examinations, including glucose profiles, lipid profiles, high-sensitivity C-reactive protein (hs-CRP) levels, and complete blood cell counts, were obtained within the first 24 hours of admission.…”

Section: Methodsmentioning

confidence: 99%

Neutrophil-to-lymphocyte ratio predicts early worsening in stroke due to large vessel disease

et al. 2019

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Background Inflammation plays an important role in atherosclerosis and its complications. Since a dysregulated inflammatory response is associated with early neurological deterioration (END), serum neutrophil-to-lymphocyte ratio (NLR) could be a marker of END as well. Aim In this study, we evaluated the relationship between the serum NLR and END in patients with ischemic stroke due to large-artery atherosclerosis (LAA). Methods We evaluated consecutive patients with ischemic stroke due to LAA between January 2010 and December 2015. END was defined as an increase ≥ 2 on the total NIHSS score or ≥ 1 on the motor NIHSS score within the first 72 hours of admission. The NLR was calculated by dividing the absolute neutrophil count by the absolute lymphocyte count. Results Of the 349 included patients, 18.1% (n = 63) had END events. In multivariate analysis, serum NLR was independently associated with END (adjusted odds ratio, 1.08; 95% confidence interval [1.00–1.16], P = 0.043). Time to admission, and in-situ thrombosis and artery-to-artery embolization mechanisms were also significantly associated with END events. In an analysis of the relationship between serum NLR and vascular lesion burden, serum NLR was positively correlated with both the degree of stenotic lesions ( P for trend = 0.006) and the number of vessel stenosis ( P for trend = 0.038) in a dose-response manner. We also compared serum NLR by the stroke mechanisms: patients with hypoperfusion or in-situ thrombosis had the highest levels of NLR: however, only those with in-situ thrombosis had significantly higher NLR in the END group compared to the non-END group ( P = 0.005). Conclusions Serum NLR levels were associated with END events in patients with ischemic stroke due to LAA. Since NLR was also closely correlated with the underlying vascular lesions, our results indicated clues for mechanisms of END events.

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The Function and Regulation of Platelet P2Y12 Receptor

Zhang²,

Cao

2021

Cardiovasc Drugs Ther

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Clopidogrel may decrease the risk of post‐stroke infection after ischaemic stroke

Abstract: The study suggested that clopidogrel users exhibit a lower risk of infection and develop less severe infections after ischaemic stroke. Further prospective studies are needed.

Cited by 8 publications

References 40 publications

Post-Stroke Infections: Insights from Big Data Using Clinical Data Warehouse (CDW)

Post-Stroke Infections: Insights from Big Data Using Clinical Data Warehouse (CDW)

Neutrophil-to-lymphocyte ratio predicts early worsening in stroke due to large vessel disease

The Function and Regulation of Platelet P2Y12 Receptor

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