Episode 67: A clot, a clot, I want it not – secondary stroke prevention with antiplatelets

Submitted by admin on Thu, 2009-09-24 00:04

In episode 67, we address ischemic stroke of arterial origin and go over some core therapies (ASA, dipyridamole, clopidogrel and warfarin).  We also discuss complications of anti-thrombotics and the options for patients with a GI bleed on ASA.  Although Peter attempts to guide us through the maze of evidence, all three of us get lost and have trouble finding our way back.

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Comments

Question/Though: We discussed

Submitted by ajaybains (not verified) on Wed, 2009-10-07 23:15.

Question/Though: We discussed this at my work and I thought it would be logical to first
go and dig up what the effect of using clopidogrel was in the first place (in
order to understand what would it be like without it). So when I compared the
results of the CURE/PCI study to the what the researchers found in the two
recent publications, I was puzzled to find that the difference observed was not
similar. Even if one assumed that omeprazole/(insert implicated PPI here) completely negated effects of Clopidogrel, it seemed to be a greater difference than origially observed in the
CURE RCT.

Any comments on this ? can you make a comparison like that?

Thanks and keep up the great podcast

I have seen numerous review

Submitted by eric (not verified) on Tue, 2010-06-15 23:04.

I have seen numerous review articles that detailed that rate control is equivalent to rhythm control in a fib. What I have not directly seen is whether or not rhythm control, perhaps with DC cardioversion (assuming the patient is 1/5 who maintains sinus rhythm without drugs) takes away the stroke risk, thus giving some benefit over rate control?

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