AustralieFrV1, PascalFrancis, Corpus, bibRecord, 002441

Effect of Clopidogrel on the Rate and Functional Severity of Stroke Among High Vascular Risk Patients: A Prespecified Substudy of the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) Trial

Identifieur interne : 002441 ( PascalFrancis/Corpus ); précédent : 002440; suivant : 002442

Effect of Clopidogrel on the Rate and Functional Severity of Stroke Among High Vascular Risk Patients: A Prespecified Substudy of the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) Trial

Auteurs : Graeme J. Hankey ; Werner Hacke ; J. Donald Easton ; S. Claiborne Johnston ; Jean-Louis Mas ; Danielle M. Brennan ; Deepak L. Bhatt ; Keith A. A. Fox ; Eric J. Topol

Source :

Stroke : (1970) [ 0039-2499 ] ; 2010.

RBID : Pascal:10-0388819

Descripteurs français

Pascal (Inist)
- Accident cérébrovasculaire, Thrombose, Ischémie, Pathologie cérébrovasculaire, Pathologie du système nerveux, Clopidogrel, Facteur risque, Homme, Conduite à tenir, Traitement, Infarctus, Prévention, Antithrombotique, Inhibiteur thromboagrégation.

English descriptors

KwdEn :
- Antiplatelet agent, Antithrombotic agent, Cerebrovascular disease, Clinical management, Clopidogrel, Human, Infarct, Ischemia, Nervous system diseases, Prevention, Risk factor, Stroke, Thrombosis, Treatment.

Abstract

Background and Purpose-Disabling stroke is costly and considered by some patients a fate worse than death. We aimed to determine whether clopidogrel reduces the rate and functional severity of stroke among high vascular risk patients, including patients with previous transient ischemic attack or ischemic stroke, who were enrolled in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) trial. Methods-We randomly assigned 15 603 high vascular risk patients to receive clopidogrel (75 mg daily) or placebo in addition to background acetylsalicylic acid and followed them for a median of 28 months. The main outcome of this prespecified substudy was the functional severity of stroke outcome events as measured by the modified Rankin Scale (mRS) score at 3 months after the stroke outcome. Results-During follow-up, 436 (2.8%) patients had a definite adjudicated stroke and a follow-up assessment of the mRS at 3 months poststroke, of whom 202 had been randomly assigned clopidogrel and 234 placebo (relative risk reduction 14%, 95% CI: -4% to 29%, P=0.12). There was no significant difference between the mean mRS scores at 3 months after stroke among patients assigned clopidogrel compared with placebo (mean mRS 3.6 [SD 2.4] clopidogrel versus 3.3 [SD 2.1] placebo; P=0.15). There was also no significant difference between the various categories of the mRS score at 3 months after stroke among patients assigned to clopidogrel compared with placebo. Among 4320 patients with a qualifying diagnosis of transient ischemic attack or ischemic stroke, 233 (5.4%) experienced a stroke during follow-up, of whom 103 were randomly assigned clopidogrel and 130 placebo (relative risk reduction 20%, 95% CI: -3% to 38%). There was no significant difference between the mean mRS scores at 3 months after stroke among patients with a qualifying transient ischemic attack or ischemic stroke who were assigned clopidogrel compared with placebo (3.4 [SD 2.1] clopidogrel versus 3.3 [SD 1.9] placebo; P=0.48). Conclusion-The addition of clopidogrel to acetylsalicylic acid did not significantly alter the rate and functional severity of stroke outcome events among high vascular risk patients enrolled in the CHARISMA trial.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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A08	`01`	`1`	`ENG`	`@1 Effect of Clopidogrel on the Rate and Functional Severity of Stroke Among High Vascular Risk Patients: A Prespecified Substudy of the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) Trial`
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A11	`03`	`1`		`@1 EASTON (J. Donald)`
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A11	`05`	`1`		`@1 MAS (Jean-Louis)`
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A14	`02`			`@1 Neurology Department Im Neuenheimer Feld 400 @2 Heidelberg @3 DEU @Z 2 aut.`
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A14	`06`			`@1 Cleveland Clinic @2 Cleveland, Ohio @3 USA @Z 6 aut.`
A14	`07`			`@1 VA Boston Healthcare System Brigham and Women's Hospital, and Harvard Medical School @2 Boston, Mass @3 USA @Z 7 aut.`
A14	`08`			`@1 University and Royal Infirmary of Edinburgh @2 Edinburgh @3 GBR @Z 8 aut.`
A14	`09`			`@1 Scripps Health and Scripps Translational Science Institute @2 La Jolla, Calif @3 USA @Z 9 aut.`
A17	`01`	`1`		`@1 CHARISMA Trial Investigators @3 USA`
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C01	`01`		`ENG`	@0 Background and Purpose-Disabling stroke is costly and considered by some patients a fate worse than death. We aimed to determine whether clopidogrel reduces the rate and functional severity of stroke among high vascular risk patients, including patients with previous transient ischemic attack or ischemic stroke, who were enrolled in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) trial. Methods-We randomly assigned 15 603 high vascular risk patients to receive clopidogrel (75 mg daily) or placebo in addition to background acetylsalicylic acid and followed them for a median of 28 months. The main outcome of this prespecified substudy was the functional severity of stroke outcome events as measured by the modified Rankin Scale (mRS) score at 3 months after the stroke outcome. Results-During follow-up, 436 (2.8%) patients had a definite adjudicated stroke and a follow-up assessment of the mRS at 3 months poststroke, of whom 202 had been randomly assigned clopidogrel and 234 placebo (relative risk reduction 14%, 95% CI: -4% to 29%, P=0.12). There was no significant difference between the mean mRS scores at 3 months after stroke among patients assigned clopidogrel compared with placebo (mean mRS 3.6 [SD 2.4] clopidogrel versus 3.3 [SD 2.1] placebo; P=0.15). There was also no significant difference between the various categories of the mRS score at 3 months after stroke among patients assigned to clopidogrel compared with placebo. Among 4320 patients with a qualifying diagnosis of transient ischemic attack or ischemic stroke, 233 (5.4%) experienced a stroke during follow-up, of whom 103 were randomly assigned clopidogrel and 130 placebo (relative risk reduction 20%, 95% CI: -3% to 38%). There was no significant difference between the mean mRS scores at 3 months after stroke among patients with a qualifying transient ischemic attack or ischemic stroke who were assigned clopidogrel compared with placebo (3.4 [SD 2.1] clopidogrel versus 3.3 [SD 1.9] placebo; P=0.48). Conclusion-The addition of clopidogrel to acetylsalicylic acid did not significantly alter the rate and functional severity of stroke outcome events among high vascular risk patients enrolled in the CHARISMA trial.
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C03	`05`	`X`	`FRE`	`@0 Pathologie du système nerveux @5 05`
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Format Inist (serveur)

NO :	PASCAL 10-0388819 INIST
ET :	Effect of Clopidogrel on the Rate and Functional Severity of Stroke Among High Vascular Risk Patients: A Prespecified Substudy of the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) Trial
AU :	HANKEY (Graeme J.); HACKE (Werner); EASTON (J. Donald); JOHNSTON (S. Claiborne); MAS (Jean-Louis); BRENNAN (Danielle M.); BHATT (Deepak L.); FOX (Keith A. A.); TOPOL (Eric J.)
AF :	Neurology Department Royal Perth Hospital/Perth/Australie (1 aut.); Neurology Department Im Neuenheimer Feld 400/Heidelberg/Allemagne (2 aut.); Brown University/Providence, RI/Etats-Unis (3 aut.); UCSF Neurology/San Francisco, Calif/Etats-Unis (4 aut.); Service de Neurologie (J.-L.M.), Hôpital Sainte-Anne/Paris/France (5 aut.); Cleveland Clinic/Cleveland, Ohio/Etats-Unis (6 aut.); VA Boston Healthcare System Brigham and Women's Hospital, and Harvard Medical School/Boston, Mass/Etats-Unis (7 aut.); University and Royal Infirmary of Edinburgh/Edinburgh/Royaume-Uni (8 aut.); Scripps Health and Scripps Translational Science Institute/La Jolla, Calif/Etats-Unis (9 aut.)
DT :	Publication en série; Niveau analytique
SO :	Stroke : (1970); ISSN 0039-2499; Coden SJCCA7; Etats-Unis; Da. 2010; Vol. 41; No. 8; Pp. 1679-1683; Bibl. 7 ref.
LA :	Anglais
EA :	Background and Purpose-Disabling stroke is costly and considered by some patients a fate worse than death. We aimed to determine whether clopidogrel reduces the rate and functional severity of stroke among high vascular risk patients, including patients with previous transient ischemic attack or ischemic stroke, who were enrolled in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) trial. Methods-We randomly assigned 15 603 high vascular risk patients to receive clopidogrel (75 mg daily) or placebo in addition to background acetylsalicylic acid and followed them for a median of 28 months. The main outcome of this prespecified substudy was the functional severity of stroke outcome events as measured by the modified Rankin Scale (mRS) score at 3 months after the stroke outcome. Results-During follow-up, 436 (2.8%) patients had a definite adjudicated stroke and a follow-up assessment of the mRS at 3 months poststroke, of whom 202 had been randomly assigned clopidogrel and 234 placebo (relative risk reduction 14%, 95% CI: -4% to 29%, P=0.12). There was no significant difference between the mean mRS scores at 3 months after stroke among patients assigned clopidogrel compared with placebo (mean mRS 3.6 [SD 2.4] clopidogrel versus 3.3 [SD 2.1] placebo; P=0.15). There was also no significant difference between the various categories of the mRS score at 3 months after stroke among patients assigned to clopidogrel compared with placebo. Among 4320 patients with a qualifying diagnosis of transient ischemic attack or ischemic stroke, 233 (5.4%) experienced a stroke during follow-up, of whom 103 were randomly assigned clopidogrel and 130 placebo (relative risk reduction 20%, 95% CI: -3% to 38%). There was no significant difference between the mean mRS scores at 3 months after stroke among patients with a qualifying transient ischemic attack or ischemic stroke who were assigned clopidogrel compared with placebo (3.4 [SD 2.1] clopidogrel versus 3.3 [SD 1.9] placebo; P=0.48). Conclusion-The addition of clopidogrel to acetylsalicylic acid did not significantly alter the rate and functional severity of stroke outcome events among high vascular risk patients enrolled in the CHARISMA trial.
CC :	002B17C; 002B17A03
FD :	Accident cérébrovasculaire; Thrombose; Ischémie; Pathologie cérébrovasculaire; Pathologie du système nerveux; Clopidogrel; Facteur risque; Homme; Conduite à tenir; Traitement; Infarctus; Prévention; Antithrombotique; Inhibiteur thromboagrégation
FG :	Dérivé de la thiénopyridine; Pathologie de l'appareil circulatoire; Pathologie de l'encéphale; Pathologie du système nerveux central; Pathologie des vaisseaux sanguins
ED :	Stroke; Thrombosis; Ischemia; Cerebrovascular disease; Nervous system diseases; Clopidogrel; Risk factor; Human; Clinical management; Treatment; Infarct; Prevention; Antithrombotic agent; Antiplatelet agent
EG :	Thienopyridine derivative; Cardiovascular disease; Cerebral disorder; Central nervous system disease; Vascular disease
SD :	Accidente cerebrovascular; Trombosis; Isquemia; Vaso sanguíneo encéfalo patología; Sistema nervioso patología; Clopidogrel; Factor riesgo; Hombre; Actitud médica; Tratamiento; Infarto; Prevención; antitrombōtico; Inhibidor tromboagregación
LO :	INIST-4004.354000191799030170
ID :	10-0388819

Links to Exploration step

Pascal:10-0388819

Le document en format XML

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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Effect of Clopidogrel on the Rate and Functional Severity of Stroke Among High Vascular Risk Patients: A Prespecified Substudy of the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) Trial</title>
<author><name sortKey="Hankey, Graeme J" sort="Hankey, Graeme J" uniqKey="Hankey G" first="Graeme J." last="Hankey">Graeme J. Hankey</name>
<affiliation><inist:fA14 i1="01"><s1>Neurology Department Royal Perth Hospital</s1>
<s2>Perth</s2>
<s3>AUS</s3>
<sZ>1 aut.</sZ>
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<author><name sortKey="Hacke, Werner" sort="Hacke, Werner" uniqKey="Hacke W" first="Werner" last="Hacke">Werner Hacke</name>
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<s2>Heidelberg</s2>
<s3>DEU</s3>
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<author><name sortKey="Easton, J Donald" sort="Easton, J Donald" uniqKey="Easton J" first="J. Donald" last="Easton">J. Donald Easton</name>
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</author>
<author><name sortKey="Johnston, S Claiborne" sort="Johnston, S Claiborne" uniqKey="Johnston S" first="S. Claiborne" last="Johnston">S. Claiborne Johnston</name>
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<s2>San Francisco, Calif</s2>
<s3>USA</s3>
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</affiliation>
</author>
<author><name sortKey="Mas, Jean Louis" sort="Mas, Jean Louis" uniqKey="Mas J" first="Jean-Louis" last="Mas">Jean-Louis Mas</name>
<affiliation><inist:fA14 i1="05"><s1>Service de Neurologie (J.-L.M.), Hôpital Sainte-Anne</s1>
<s2>Paris</s2>
<s3>FRA</s3>
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</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Brennan, Danielle M" sort="Brennan, Danielle M" uniqKey="Brennan D" first="Danielle M." last="Brennan">Danielle M. Brennan</name>
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</author>
<author><name sortKey="Bhatt, Deepak L" sort="Bhatt, Deepak L" uniqKey="Bhatt D" first="Deepak L." last="Bhatt">Deepak L. Bhatt</name>
<affiliation><inist:fA14 i1="07"><s1>VA Boston Healthcare System Brigham and Women's Hospital, and Harvard Medical School</s1>
<s2>Boston, Mass</s2>
<s3>USA</s3>
<sZ>7 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Fox, Keith A A" sort="Fox, Keith A A" uniqKey="Fox K" first="Keith A. A." last="Fox">Keith A. A. Fox</name>
<affiliation><inist:fA14 i1="08"><s1>University and Royal Infirmary of Edinburgh</s1>
<s2>Edinburgh</s2>
<s3>GBR</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Topol, Eric J" sort="Topol, Eric J" uniqKey="Topol E" first="Eric J." last="Topol">Eric J. Topol</name>
<affiliation><inist:fA14 i1="09"><s1>Scripps Health and Scripps Translational Science Institute</s1>
<s2>La Jolla, Calif</s2>
<s3>USA</s3>
<sZ>9 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Stroke : (1970)</title>
<title level="j" type="abbreviated">Stroke : (1970)</title>
<idno type="ISSN">0039-2499</idno>
<imprint><date when="2010">2010</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Stroke : (1970)</title>
<title level="j" type="abbreviated">Stroke : (1970)</title>
<idno type="ISSN">0039-2499</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antiplatelet agent</term>
<term>Antithrombotic agent</term>
<term>Cerebrovascular disease</term>
<term>Clinical management</term>
<term>Clopidogrel</term>
<term>Human</term>
<term>Infarct</term>
<term>Ischemia</term>
<term>Nervous system diseases</term>
<term>Prevention</term>
<term>Risk factor</term>
<term>Stroke</term>
<term>Thrombosis</term>
<term>Treatment</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Accident cérébrovasculaire</term>
<term>Thrombose</term>
<term>Ischémie</term>
<term>Pathologie cérébrovasculaire</term>
<term>Pathologie du   système nerveux</term>
<term>Clopidogrel</term>
<term>Facteur risque</term>
<term>Homme</term>
<term>Conduite à tenir</term>
<term>Traitement</term>
<term>Infarctus</term>
<term>Prévention</term>
<term>Antithrombotique</term>
<term>Inhibiteur thromboagrégation</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background and Purpose-Disabling stroke is costly and considered by some patients a fate worse than death. We aimed to determine whether clopidogrel reduces the rate and functional severity of stroke among high vascular risk patients, including patients with previous transient ischemic attack or ischemic stroke, who were enrolled in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) trial. Methods-We randomly assigned 15 603 high vascular risk patients to receive clopidogrel (75 mg daily) or placebo in addition to background acetylsalicylic acid and followed them for a median of 28 months. The main outcome of this prespecified substudy was the functional severity of stroke outcome events as measured by the modified Rankin Scale (mRS) score at 3 months after the stroke outcome. Results-During follow-up, 436 (2.8%) patients had a definite adjudicated stroke and a follow-up assessment of the mRS at 3 months poststroke, of whom 202 had been randomly assigned clopidogrel and 234 placebo (relative risk reduction 14%, 95% CI: -4% to 29%, P=0.12). There was no significant difference between the mean mRS scores at 3 months after stroke among patients assigned clopidogrel compared with placebo (mean mRS 3.6 [SD 2.4] clopidogrel versus 3.3 [SD 2.1] placebo; P=0.15). There was also no significant difference between the various categories of the mRS score at 3 months after stroke among patients assigned to clopidogrel compared with placebo. Among 4320 patients with a qualifying diagnosis of transient ischemic attack or ischemic stroke, 233 (5.4%) experienced a stroke during follow-up, of whom 103 were randomly assigned clopidogrel and 130 placebo (relative risk reduction 20%, 95% CI: -3% to 38%). There was no significant difference between the mean mRS scores at 3 months after stroke among patients with a qualifying transient ischemic attack or ischemic stroke who were assigned clopidogrel compared with placebo (3.4 [SD 2.1] clopidogrel versus 3.3 [SD 1.9] placebo; P=0.48). Conclusion-The addition of clopidogrel to acetylsalicylic acid did not significantly alter the rate and functional severity of stroke outcome events among high vascular risk patients enrolled in the CHARISMA trial.</div>
</front>
</TEI>
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<fA05><s2>41</s2>
</fA05>
<fA06><s2>8</s2>
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<fA08 i1="01" i2="1" l="ENG"><s1>Effect of Clopidogrel on the Rate and Functional Severity of Stroke Among High Vascular Risk Patients: A Prespecified Substudy of the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) Trial</s1>
</fA08>
<fA11 i1="01" i2="1"><s1>HANKEY (Graeme J.)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>HACKE (Werner)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>EASTON (J. Donald)</s1>
</fA11>
<fA11 i1="04" i2="1"><s1>JOHNSTON (S. Claiborne)</s1>
</fA11>
<fA11 i1="05" i2="1"><s1>MAS (Jean-Louis)</s1>
</fA11>
<fA11 i1="06" i2="1"><s1>BRENNAN (Danielle M.)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>BHATT (Deepak L.)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>FOX (Keith A. A.)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>TOPOL (Eric J.)</s1>
</fA11>
<fA14 i1="01"><s1>Neurology Department Royal Perth Hospital</s1>
<s2>Perth</s2>
<s3>AUS</s3>
<sZ>1 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Neurology Department Im Neuenheimer Feld 400</s1>
<s2>Heidelberg</s2>
<s3>DEU</s3>
<sZ>2 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>Brown University</s1>
<s2>Providence, RI</s2>
<s3>USA</s3>
<sZ>3 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>UCSF Neurology</s1>
<s2>San Francisco, Calif</s2>
<s3>USA</s3>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Service de Neurologie (J.-L.M.), Hôpital Sainte-Anne</s1>
<s2>Paris</s2>
<s3>FRA</s3>
<sZ>5 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>Cleveland Clinic</s1>
<s2>Cleveland, Ohio</s2>
<s3>USA</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>VA Boston Healthcare System Brigham and Women's Hospital, and Harvard Medical School</s1>
<s2>Boston, Mass</s2>
<s3>USA</s3>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="08"><s1>University and Royal Infirmary of Edinburgh</s1>
<s2>Edinburgh</s2>
<s3>GBR</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="09"><s1>Scripps Health and Scripps Translational Science Institute</s1>
<s2>La Jolla, Calif</s2>
<s3>USA</s3>
<sZ>9 aut.</sZ>
</fA14>
<fA17 i1="01" i2="1"><s1>CHARISMA Trial Investigators</s1>
<s3>USA</s3>
</fA17>
<fA20><s1>1679-1683</s1>
</fA20>
<fA21><s1>2010</s1>
</fA21>
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</fA23>
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<s2>4004</s2>
<s5>354000191799030170</s5>
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<fA44><s0>0000</s0>
<s1>© 2010 INIST-CNRS. All rights reserved.</s1>
</fA44>
<fA45><s0>7 ref.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>10-0388819</s0>
</fA47>
<fA60><s1>P</s1>
</fA60>
<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>Stroke : (1970)</s0>
</fA64>
<fA66 i1="01"><s0>USA</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>Background and Purpose-Disabling stroke is costly and considered by some patients a fate worse than death. We aimed to determine whether clopidogrel reduces the rate and functional severity of stroke among high vascular risk patients, including patients with previous transient ischemic attack or ischemic stroke, who were enrolled in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) trial. Methods-We randomly assigned 15 603 high vascular risk patients to receive clopidogrel (75 mg daily) or placebo in addition to background acetylsalicylic acid and followed them for a median of 28 months. The main outcome of this prespecified substudy was the functional severity of stroke outcome events as measured by the modified Rankin Scale (mRS) score at 3 months after the stroke outcome. Results-During follow-up, 436 (2.8%) patients had a definite adjudicated stroke and a follow-up assessment of the mRS at 3 months poststroke, of whom 202 had been randomly assigned clopidogrel and 234 placebo (relative risk reduction 14%, 95% CI: -4% to 29%, P=0.12). There was no significant difference between the mean mRS scores at 3 months after stroke among patients assigned clopidogrel compared with placebo (mean mRS 3.6 [SD 2.4] clopidogrel versus 3.3 [SD 2.1] placebo; P=0.15). There was also no significant difference between the various categories of the mRS score at 3 months after stroke among patients assigned to clopidogrel compared with placebo. Among 4320 patients with a qualifying diagnosis of transient ischemic attack or ischemic stroke, 233 (5.4%) experienced a stroke during follow-up, of whom 103 were randomly assigned clopidogrel and 130 placebo (relative risk reduction 20%, 95% CI: -3% to 38%). There was no significant difference between the mean mRS scores at 3 months after stroke among patients with a qualifying transient ischemic attack or ischemic stroke who were assigned clopidogrel compared with placebo (3.4 [SD 2.1] clopidogrel versus 3.3 [SD 1.9] placebo; P=0.48). Conclusion-The addition of clopidogrel to acetylsalicylic acid did not significantly alter the rate and functional severity of stroke outcome events among high vascular risk patients enrolled in the CHARISMA trial.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B17C</s0>
</fC02>
<fC02 i1="02" i2="X"><s0>002B17A03</s0>
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<fC03 i1="01" i2="X" l="FRE"><s0>Accident cérébrovasculaire</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Stroke</s0>
<s5>01</s5>
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<fC03 i1="01" i2="X" l="SPA"><s0>Accidente cerebrovascular</s0>
<s5>01</s5>
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<s5>03</s5>
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<s5>03</s5>
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<fC03 i1="03" i2="X" l="SPA"><s0>Isquemia</s0>
<s5>03</s5>
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<s5>04</s5>
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<fC03 i1="06" i2="X" l="ENG"><s0>Clopidogrel</s0>
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<fC03 i1="06" i2="X" l="SPA"><s0>Clopidogrel</s0>
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<s5>10</s5>
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<s5>11</s5>
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<s5>11</s5>
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<s5>14</s5>
</fC03>
<fC03 i1="11" i2="X" l="ENG"><s0>Infarct</s0>
<s5>14</s5>
</fC03>
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<s5>14</s5>
</fC03>
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<s5>15</s5>
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<s5>15</s5>
</fC03>
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<s5>15</s5>
</fC03>
<fC03 i1="13" i2="X" l="FRE"><s0>Antithrombotique</s0>
<s5>78</s5>
</fC03>
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<s5>78</s5>
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<s5>79</s5>
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<s5>37</s5>
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<s5>38</s5>
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<s5>38</s5>
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<s5>39</s5>
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<s5>39</s5>
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<s5>39</s5>
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<s5>40</s5>
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<s5>40</s5>
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<s5>40</s5>
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<s5>42</s5>
</fC07>
<fC07 i1="05" i2="X" l="ENG"><s0>Vascular disease</s0>
<s5>42</s5>
</fC07>
<fC07 i1="05" i2="X" l="SPA"><s0>Vaso sanguíneo patología</s0>
<s5>42</s5>
</fC07>
<fN21><s1>249</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
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</pA>
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<server><NO>PASCAL 10-0388819 INIST</NO>
<ET>Effect of Clopidogrel on the Rate and Functional Severity of Stroke Among High Vascular Risk Patients: A Prespecified Substudy of the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) Trial</ET>
<AU>HANKEY (Graeme J.); HACKE (Werner); EASTON (J. Donald); JOHNSTON (S. Claiborne); MAS (Jean-Louis); BRENNAN (Danielle M.); BHATT (Deepak L.); FOX (Keith A. A.); TOPOL (Eric J.)</AU>
<AF>Neurology Department Royal Perth Hospital/Perth/Australie (1 aut.); Neurology Department Im Neuenheimer Feld 400/Heidelberg/Allemagne (2 aut.); Brown University/Providence, RI/Etats-Unis (3 aut.); UCSF Neurology/San Francisco, Calif/Etats-Unis (4 aut.); Service de Neurologie (J.-L.M.), Hôpital Sainte-Anne/Paris/France (5 aut.); Cleveland Clinic/Cleveland, Ohio/Etats-Unis (6 aut.); VA Boston Healthcare System Brigham and Women's Hospital, and Harvard Medical School/Boston, Mass/Etats-Unis (7 aut.); University and Royal Infirmary of Edinburgh/Edinburgh/Royaume-Uni (8 aut.); Scripps Health and Scripps Translational Science Institute/La Jolla, Calif/Etats-Unis (9 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Stroke : (1970); ISSN 0039-2499; Coden SJCCA7; Etats-Unis; Da. 2010; Vol. 41; No. 8; Pp. 1679-1683; Bibl. 7 ref.</SO>
<LA>Anglais</LA>
<EA>Background and Purpose-Disabling stroke is costly and considered by some patients a fate worse than death. We aimed to determine whether clopidogrel reduces the rate and functional severity of stroke among high vascular risk patients, including patients with previous transient ischemic attack or ischemic stroke, who were enrolled in the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) trial. Methods-We randomly assigned 15 603 high vascular risk patients to receive clopidogrel (75 mg daily) or placebo in addition to background acetylsalicylic acid and followed them for a median of 28 months. The main outcome of this prespecified substudy was the functional severity of stroke outcome events as measured by the modified Rankin Scale (mRS) score at 3 months after the stroke outcome. Results-During follow-up, 436 (2.8%) patients had a definite adjudicated stroke and a follow-up assessment of the mRS at 3 months poststroke, of whom 202 had been randomly assigned clopidogrel and 234 placebo (relative risk reduction 14%, 95% CI: -4% to 29%, P=0.12). There was no significant difference between the mean mRS scores at 3 months after stroke among patients assigned clopidogrel compared with placebo (mean mRS 3.6 [SD 2.4] clopidogrel versus 3.3 [SD 2.1] placebo; P=0.15). There was also no significant difference between the various categories of the mRS score at 3 months after stroke among patients assigned to clopidogrel compared with placebo. Among 4320 patients with a qualifying diagnosis of transient ischemic attack or ischemic stroke, 233 (5.4%) experienced a stroke during follow-up, of whom 103 were randomly assigned clopidogrel and 130 placebo (relative risk reduction 20%, 95% CI: -3% to 38%). There was no significant difference between the mean mRS scores at 3 months after stroke among patients with a qualifying transient ischemic attack or ischemic stroke who were assigned clopidogrel compared with placebo (3.4 [SD 2.1] clopidogrel versus 3.3 [SD 1.9] placebo; P=0.48). Conclusion-The addition of clopidogrel to acetylsalicylic acid did not significantly alter the rate and functional severity of stroke outcome events among high vascular risk patients enrolled in the CHARISMA trial.</EA>
<CC>002B17C; 002B17A03</CC>
<FD>Accident cérébrovasculaire; Thrombose; Ischémie; Pathologie cérébrovasculaire; Pathologie du système nerveux; Clopidogrel; Facteur risque; Homme; Conduite à tenir; Traitement; Infarctus; Prévention; Antithrombotique; Inhibiteur thromboagrégation</FD>
<FG>Dérivé de la thiénopyridine; Pathologie de l'appareil circulatoire; Pathologie de l'encéphale; Pathologie du   système nerveux central; Pathologie des vaisseaux sanguins</FG>
<ED>Stroke; Thrombosis; Ischemia; Cerebrovascular disease; Nervous system diseases; Clopidogrel; Risk factor; Human; Clinical management; Treatment; Infarct; Prevention; Antithrombotic agent; Antiplatelet agent</ED>
<EG>Thienopyridine derivative; Cardiovascular disease; Cerebral disorder; Central nervous system disease; Vascular disease</EG>
<SD>Accidente cerebrovascular; Trombosis; Isquemia; Vaso sanguíneo encéfalo patología; Sistema nervioso patología; Clopidogrel; Factor riesgo; Hombre; Actitud médica; Tratamiento; Infarto; Prevención; antitrombōtico; Inhibidor tromboagregación</SD>
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Effect of Clopidogrel on the Rate and Functional Severity of Stroke Among High Vascular Risk Patients: A Prespecified Substudy of the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) Trial

Effect of Clopidogrel on the Rate and Functional Severity of Stroke Among High Vascular Risk Patients: A Prespecified Substudy of the Clopidogrel for High Atherothrombotic Risk and Ischemic Stabilization, Management and Avoidance (CHARISMA) Trial

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