NEWS HIGHLIGHTSMedia Articles Related to Aggrenox (Aspirin / Dipyridamole)
Migraine Patients Who Experience Aura May Have A Two-Fold Increased Risk For Ischemic Stroke
Source: Headache / Migraine News From Medical News Today [2009.09.16]
A systematic review and meta-analysis of case-control and cohort studies finds that patients with migraine with aura have a two-fold increased risk for ischemic stroke compared to non-migraineurs. This association does not appear among migraineurs without aura[i]. Migraine with aura is often characterized by visual disturbances such as flashes of light, zigzagging patterns or even blind spots, which are then followed by a migraine attack.
Investigational Neurostimulation Device Aims To Reduce Stroke Damage
Source: Medical Devices / Diagnostics News From Medical News Today [2009.11.18]
Stroke researchers at the Methodist Neurological Institute in Houston are the only ones in Texas to offer a novel device that might extend the acute stroke treatment window from three hours to 24. The miniature neurostimulator, about the size of a staple, is implanted near the sphenopalatine ganglion, a nerve located in the roof of the patient's mouth, within 24 hours of the onset of acute ischemic stroke.
Published Studies Related to Aggrenox (Aspirin / Dipyridamole)
Antiplatelet profiles of the fixed-dose combination of extended-release dipyridamole and low-dose aspirin compared with clopidogrel with or without aspirin in patients with type 2 diabetes and a history of transient ischemic attack: A randomized, single-blind, 30-day trial. [2008.02]
Background: Clopidogrel, aspirin (ASA), and the fixed-dose combination of extended-release dipyridamole and ASA (ER-DP+ASA) are widely used in post-stroke regimens. Objective: This study compared serial changes in multiple biomarkers of platelet activation with ER-DP+ASA and clopidogrel with or without ASA in patients with type 2 diabetes mellitus and a history of transient ischemic attack (TIA)...
Magnitude and time course of platelet inhibition with extended release dipyridamole with or without aspirin in healthy Japanese volunteers. The AGgrenox versus Aspirin Therapy Evaluation (AGATE-Japan). [2008.01]
Randomized trials showed greater stroke prevention with extended release dipyridamole in combination with low dose aspirin than with either aspirin or dipyridamole alone. However, most studies with this formulation (Aggrenox) were carried out in Europe and North America... A larger study to assess drug efficacy and safety in the Japanese post-stroke patients is warranted.
Effects of aspirin, clopidogrel and dipyridamole administered singly and in combination on platelet and leucocyte function in normal volunteers and patients with prior ischaemic stroke. [2005.03]
The aim of this study was to assess whether triple antiplatelet therapy is superior to dual and mono therapy in attenuating platelet and leucocyte function. Aspirin (A), clopidogrel (C), and dipyridamole (D) were administered singly and in various combinations (A, C, D, AC, AD, CD, ACD), each for two weeks (without washout) to 11 healthy subjects and to 11 patients with previous ischaemic stroke in two randomised multiway crossover trials...
Design of the Dialysis Access Consortium (DAC) Aggrenox Prevention Of Access Stenosis Trial. [2005]
BACKGROUND: Surgically created arteriovenous (AV) grafts are the most common type of hemodialysis vascular access in the United States, but fail frequently due to the development of venous stenosis. The Dialysis Access Consortium (DAC) Aggrenox Prevention of Access Stenosis Trial tests the hypothesis that Aggrenox (containing dipyridamole and aspirin) can prevent stenosis and prolong survival of arteriovenous grafts... CONCLUSIONS: This is the first, large, multicenter trial evaluating a pharmacologic approach to prevent AV graft stenosis and failure, an important and costly problem in this patient population. Numerous design issues were addressed in implementing the trial and these will form a roadmap for future trials in this area.
Acetaminophen in the treatment of headaches associated with dipyridamole-aspirin combination. [2004.09.28]
The authors assessed the prevalence of headaches following extended-release dipyridamole/aspirin combination (DAC), and the efficacy of acetaminophen in the treatment of these headaches. Following DAC, 38.7% of the participants developed headaches... Acetaminophen was no more effective than placebo in the acute and preemptive treatment of these headaches.
Clinical Trials Related to Aggrenox (Aspirin / Dipyridamole)
JASAP: Japanese Aggrenox Stroke Prevention vs. Aspirin Programme [Active, not recruiting]
Phase III study to compare the preventive effect of recurrent brain infarction and safety of
Aggrenox (combination drug containing sustained-release dipyridamole 200 mg/acetylsalicylic
acid 25 mg) twice daily vs. acetylsalicylic acid 81 mg once daily
Headache Study to Compare Aggrenox Full Dose and Reduced Dose [Completed]
Tolerability of a four weeks treatment with Aggrenox® modified release capsules b. i.d,
compared to reduced dose during the first two weeks of treatment in a double-blind,
randomized controlled parallel group comparison trial among Taiwanese patients with previous
TIA's or ischemic stroke. To monitor frequency and intensity of headaches and other safety
parameters among Taiwanese patients with previous TIA's or ischemic stroke given Aggrenox
using a titration scheme or not
EARLY 3-Months Aggrenox Treatment Started Within 24 Hrs of Ischemic Stroke Onset vs. After One Week 100 mg ASA [Recruiting]
German stroke units are hesitating to use Aggrenox for secondary ischaemic stroke / transient
ischaemic attack (TIA) prevention in a sub-acute treatment setting. They argue that clinical
experience with sub-acute Aggrenox treatment is limited and poorly documented when compared
with sub-acute acetylsalicylic acid (ASA) treatment. However, long term treatment (started
after 3-6 months after stroke/TIA) with Aggrenox was safe and superior to ASA treatment in
preventing recurrent strokes. There is no evidence for ASA to prevent from neurological
progression after stroke during the first 3 months. Results from a cohort study suggest that
starting Aggrenox within 72 hours after stroke predicts clinical improvement in the NIHSS at
discharge from the hospital. Dipyridamole suppresses acute inflammatory responses to stroke.
This study is designed to investigate the tolerability and efficacy of a secondary stroke
prevention treatment with Aggrenox when initiated within 24 hours of stroke onset on a stroke
unit compared to later initiation after a 7 day ASA treatment and outside off a stroke unit
setting.
Vascular Access Clinical Trials Data Coordinating Center [Completed]
Fistula Study: The objective of the study is to determine whether clopidogrel reduces the
early failure rate of native AV fistulae.
Graft Study: The objective of the study is to determine whether Aggrenox
(Boehringer-Ingelheim) prolongs primary unassisted patency in newly created arteriovenous
grafts.
Treatment of Supine Hypertension in Autonomic Failure [Recruiting]
Supine hypertension is a common problem that affects at least 50% of patients with primary
autonomic failure. Supine hypertension can be severe, and complicates the treatment of
orthostatic hypotension. Drugs used for the treatment of orthostatic hypotension (eg,
fludrocortisone and pressor agents), worsen supine hypertension. High blood pressure may
also cause target organ damage in this group of patients. The pathophysiologic mechanisms
causing supine hypertension in patients with autonomic failure have not been defined.
In a study, we, the investigators at Vanderbilt University, examined 64 patients with AF, 29
with pure autonomic failure (PAF) and 35 with multiple system atrophy (MSA). 66% of patients
had supine systolic (systolic blood pressure [SBP] > 150 mmHg) or diastolic (diastolic blood
pressure [DBP] > 90 mmHg) hypertension (average blood pressure [BP]: 179 ± 5/89 ± 3 mmHg in
21 PAF and 175 ± 5/92 ± 3 mmHg in 21 MSA patients). Plasma norepinephrine (92 ± 15 pg/mL)
and plasma renin activity (0. 3 ± 0. 05 ng/mL per hour) were very low in a subset of patients
with AF and supine hypertension. (Shannon et al., 1997).
Our group has showed that a residual sympathetic function contributes to supine hypertension
in patients with severe autonomic failure and that this effect is more prominent in patients
with MSA than in those with PAF (Shannon et al., 2000). MSA patients had a marked depressor
response to low infusion rates of trimethaphan, a ganglionic blocker; the response in PAF
patients was more variable. At 1 mg/min, trimethaphan decreased supine SBP by 67 +/- 8 and
12 +/- 6 mmHg in MSA and PAF patients, respectively (P < 0. 0001). MSA patients with supine
hypertension also had greater SBP response to oral yohimbine, a central alpha2 receptor
blocker, than PAF patients. Plasma norepinephrine decreased in both groups, but heart rate
did not change in either group. This result suggests that residual sympathetic activity
drives supine hypertension in MSA; in contrast, supine hypertension in PAF.
It is hoped that from this study will emerge a complete picture of the supine hypertension
of autonomic failure. Understanding the mechanism of this paradoxical hypertension in the
setting of profound loss of sympathetic function will improve our approach to the treatment
of hypertension in autonomic failure, and it could also contribute to our understanding of
hypertension in general.
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