Trial reportAJNR. American journal of neuroradiology2013
Clopidogrel hyper-response and bleeding risk in neurointerventional procedures.
Trial report in AJNR. American journal of neuroradiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 36 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
36 citing papers in PubMed, 1 synthesis or guideline pooled it, 86 citations in OpenAlex.
- A systematic review and meta-analysis of the impact of clopidogrel responsiveness on ischemic and bleeding complications after noncoronary endovascular procedures.Journal of vascular surgery · 2026Pooled it
- Short- versus long-term Dual AntiPlatelet Therapy for Stent-Assisted treatment of CErebral aneurysm (DAPTS ACE): a multicenter, open-label, randomized clinical trial.Journal of neurointerventional surgery · 2024Trial
- Antiplatelet Therapy and Platelet Activity Testing for Neurointerventional Procedures.Stroke (Hoboken, N.J.) · 2025Review
- Variability patterns in dual antiplatelet therapy following endovascular repair of intracranial aneurysms: Insight into regimen heterogeneity and the need for a consensus.Acta neurochirurgica · 2024Review
- Classification and hemodynamic characteristics of delayed intracerebral hemorrhage following stent-assisted coil embolism in unruptured intracranial aneurysms.Frontiers in neurology · 2024Article
- Article
- Paraclinoid internal carotid artery aneurysm with delayed stent occlusion after deployment of a flow diverter stent involving the orifice of the anterior cerebral artery: illustrative case.Journal of neurosurgery. Case lessons · 2023Article
- Antiplatelet Resistance: A Review of Concepts, Mechanisms, and Implications for Management in Acute Ischemic Stroke and Transient Ischemic Attack.Stroke (Hoboken, N.J.) · 2023Review
- P2Y12 inhibitors for the neurointerventionalist.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2022Review
- Dual Testing to Achieve Low On-treatment Platelet Reactivity for Aneurysm Embolization.Clinical neuroradiology · 2021Article
- Safety of Oral P2Y12 Inhibitors in Interventional Neuroradiology: Current Status and Perspectives.AJNR. American journal of neuroradiology · 2021Review
- Long-term complications after stent assist coiling dependent on clopidogrel response.BMC neurology · 2021Article
- Efficacy of Monitoring for Multiple Antiplatelet Therapy during Intracranial Stent Placement: A Preliminary Study.Journal of neuroendovascular therapy · 2021Article
- Initial Report of the Perioperative Platelet Aggregation Test Using Hematracer ZEN in Neuroendovascular Therapy.Journal of neuroendovascular therapy · 2021Article
- Tailored antiplatelet agent medication in clopidogrel hyporesponsive patients before stent-assisted coiling: single-center experience.Neuroradiology · 2020Article
- Antiplatelet Drugs for Neurointerventions: Part 1 Clinical Pharmacology.Clinical neuroradiology · 2020Review
- The Evolution of Flow-Diverting Stents for Cerebral Aneurysms; Historical Review, Modern Application, Complications, and Future Direction.Journal of Korean Neurosurgical Society · 2020Article
- Risk Factor Analysis of Delayed Intracerebral Hemorrhage After Coil Embolization of Unruptured Cerebral Aneurysms.Frontiers in neurology · 2020Article
- Standard vs. Modified Antiplatelet Therapy Based on Thromboelastography With Platelet Mapping for Preventing Bleeding Events in Patients Undergoing Stent-Assisted Coil for a Ruptured Intracranial Aneurysm.Frontiers in neurology · 2020Article
- Ticagrelor Use in Indian Patients Undergoing Neuroendovascular Procedures: A Single Center Experience.Neurointervention · 2019Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
background and purposeAntiplatelet therapy is associated with decreased ischemic events after neurointerventional procedures. Antiplatelet resistance negates the protective effects of antiplatelet medication, leading to a higher incidence of ischemic events. A possible link between antiplatelet hyper-response and increased hemorrhagic complications has been inadequately investigated. We aimed to examine the correlation between antiplatelet hyper-response and the risk of hemorrhagic complications. MATERIALS AND
methodsPatients who were treated with antiplatelet medications and underwent neurointerventional procedures were prospectively recruited. We collected the following data: demographics, vascular risk factors, antiplatelet and anticoagulation treatment, antiplatelet responsiveness, coagulation profile, and hemorrhagic complications. P2Y12 receptor-mediated platelet inhibition was tested by using the VerifyNow assay device. The primary end points were postprocedural major and minor hemorrhagic complications. Receiver operator characteristic analysis was used to evaluate the percentage of platelet inhibition as a diagnostic tool for bleeding events. The association between hemorrhage and percentage of platelet inhibition was investigated by using logistic regression modeling.
resultsForty-seven patients were enrolled. The mean age was 56±12 years, and 28% were men. Ten patients (21.3%) developed hemorrhagic complications. Clopidogrel response was higher in patients with a major bleeding complication compared with those with minor or no bleeding (median, 94% versus 24% platelet inhibition; P=.0084). Of the 7 patients (14.9%) defined as hyper-responders with ≥72% platelet inhibition, 42.8% had a major bleeding complication.
conclusionsHyper-response to clopidogrel is associated with increased risk of hemorrhagic complications. Larger studies are urgently needed to validate a clinically useful threshold to define clopidogrel hyper-response and to examine the clinical effects of antiplatelet dosage adjustment.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.