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Huang H, Zhang S, Du H, Guo Y, Zheng H. Effect of Clopidogrel combined with aspirin in the treatment of acute progressive cerebral infarction: A retrospective single-center analysis. Pak J Med Sci 2024; 40:891-895. [PMID: 38827855 PMCID: PMC11140315 DOI: 10.12669/pjms.40.5.9206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/02/2023] [Accepted: 02/13/2024] [Indexed: 06/05/2024] Open
Abstract
Objective To explore the effect of clopidogrel combined with aspirin in the treatment of acute progressive cerebral infarction (APCI). Methods We retrospectively analyzed the records of 190 patients with APCI admitted to Chengdu First People's Hospital from September 2020 to April 2023. The records were divided into an aspirin group (76 cases), a clopidogrel group (72 cases), and a clopidogrel plus aspirin group (42 cases) according to the treatment records. We compared the efficacy of the three treatment outcomes by analyzing the National Institutes of Health Stroke Scale (NIHSS) scores, and the levels of serum inflammatory factors (IL-8, TNF-α, and IL-1β), cone like protein-1 (VILIP-1), and caveolin-1 (Cav-1). Results The total efficacy of the combination group (97.62%) was significantly higher than those of the aspirin group (73.68%) or the clopidogrel group (79.17%) (p<0.05). After treatment, the NIHSS scores, inflammatory factor levels, serum VILIP-1 and Cav-1 levels were significantly lower than those before treatment in the three groups, but all the levels were significantly lower in the combination group (all p<0.05). Conclusions Our results indicate that compared with aspirin alone or clopidogrel alone, the combination of aspirin and clopidogrel is more effective for the treatment of APCI. The combination regimen effectively lowers serum inflammatory factors (IL-8, TNF-α, and IL-1β), as well as the VILIP-1 and Cav-1 levels.
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Affiliation(s)
- Huiying Huang
- Huiying Huang, Department of Neurology, People’s Hospital of Leshan, Leshan, Sichuan Province 614000, P.R. China
| | - Shan Zhang
- Shan Zhang, Department of Neurology, People’s Hospital of Leshan, Leshan, Sichuan Province 614000, P.R. China
| | - Hong Du
- Hong Du, Department of Neurology, People’s Hospital of Leshan, Leshan, Sichuan Province 614000, P.R. China
| | - Yonghua Guo
- Yonghua Guo, Department of Neurology, People’s Hospital of Leshan, Leshan, Sichuan Province 614000, P.R. China
| | - Hui Zheng
- Hui Zheng Department of Neurology, Chengdu First People’s Hospital, 18 Wanxiang North Road, Chengdu, Sichuan Province 610095, P.R. China
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Chen X, Zhu W, Liu H, Deng F, Wang W, Qin L. Preparation of injectable clopidogrel loaded submicron emulsion for enhancing physicochemical stability and anti-thrombotic efficacy. Int J Pharm 2022; 611:121323. [PMID: 34848363 DOI: 10.1016/j.ijpharm.2021.121323] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 11/11/2021] [Accepted: 11/24/2021] [Indexed: 01/13/2023]
Abstract
Due to the superior safety and therapeutic efficacy, clopidogrel (CLP) has been widely used to prevent postoperative thrombosis. However, limitations of delayed absorption and metabolic activation of clopidogrel after oral administration hinder its clinic use for acute thrombosis treatment in percutaneous coronary intervention (PCI). Although clopidogrel aqueous injection systems were designed and developed, chemical instability under physiological condition or vascular irritation remains to be solved. In this study, we aim to prepare an injectable clopidogrel loaded submicron emulsion to overcome the drawbacks of conventional clopidogrel aqueous formulation and improve the antiplatelet aggregation effects. Results showed that this delivery system exerted inspiring features including uniform particle size, higher drug loading capacity and sustained drug release behavior. It can dramatically upgrade the formulation stability and prevent the drug degradation under sterilization or higher pH environments. No remarkable droplet size increase or drug content decrease was observed during storage. Compared to CLP tablet, the peak drug concentration (Cmax) and area under the curve (AUC) of CLP emulsion increased by 12.01-fold and 4.69-fold, respectively. Most importantly, it exerted excellent in vivo anti-thrombotic effect on numerous designed animal models. Conclusively, submicron emulsion is a promising delivery system for improving clopidogrel stability and anti-thrombotic efficacy.
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Affiliation(s)
- Xuehong Chen
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China; The Information Area of Xihu Industrial Base Shilong Town, Dongguan 523000, China
| | - Wanye Zhu
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Huan Liu
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Fengjian Deng
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China
| | - Wanting Wang
- HEC Industrial Development Co. Changan Town, Dongguan 523000, China.
| | - Linghao Qin
- School of Pharmacy, Guangdong Pharmaceutical University, Guangzhou 510006, China.
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Wang Y, Xu J, Yang J, Zhang L, Pan Y, Dou L, Zhou P, Xu Y, Li C, He Y, Zhou H, Yu L, Chen J, Huang S, Fu W, Wan H. Effects of Guanxinshutong Capsules as Complementary Treatment in Patients With Chronic Heart Failure: Study Protocol for a Randomized Controlled Trial. Front Pharmacol 2021; 11:571106. [PMID: 33519434 PMCID: PMC7840487 DOI: 10.3389/fphar.2020.571106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 10/30/2020] [Indexed: 12/11/2022] Open
Abstract
Chronic heart failure (CHF) is a common cardiovascular disease with high mortality and a poor prognosis, which places heavy burdens upon society and families. Traditional Chinese medicine (TCM) has been used extensively as complementary treatment for CHF. Guanxinshutong (GXST) capsules are used commonly for the treatment of coronary heart disease (CHD). Experimental research and small-sample clinical trials have shown that GXST can attenuate CHF. However, the effects of GXST as complementary medicine in CHF treatment lack high-quality clinical evidence. We have designed a multicenter, randomized, double-blind, placebo-controlled clinical trial that explores the efficacy and safety of using GXST compared with placebo for patients with CHF with reduced left ventricular ejection fraction (LVEF). A total of 480 participants will be assigned randomly to the GXST group or placebo group at a 2:1 ratio. GXST and placebo will be added to standard treatment for 12 weeks, and then followed up for another 40 weeks. The primary outcome is the improvement value of 6-min walk distance, and the secondary outcomes include plasma levels of N-terminal pro-B-type natriuretic peptide, New York Heart Association classification, Minnesota Living with Heart Failure Questionnaire scores, echocardiographic parameters, and clinical endpoint events. Adverse events will be monitored throughout the trial. Data will be analyzed following a predefined statistical analysis plan. This study will show the effects of the specific use of GXST in CHF patients with reduced LVEF. The Research Ethics Committee of the Second Affiliated Hospital of Zhejiang Chinese Medical University has approved this study (2019-Y-003-02). Written informed consent of patients will be required. This trial is registered in the Chinese Clinical Trial Registry (ChiCTR1900023877). Our results will be disseminated to the public through peer-reviewed journals, academic conferences, and the Internet.
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Affiliation(s)
- Yu Wang
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiaping Xu
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiehong Yang
- School of Basic Medicine and Public Health, Zhejiang Chinese Medical University, Hangzhou, China
| | - Ling Zhang
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuanjiang Pan
- Department of Chemistry, Zhejiang University, Hangzhou, China
| | - Liping Dou
- Department of Cardiology, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Peng Zhou
- Institute of Brain and Heart CO Treatment, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yizhou Xu
- Department of Cardiology, Hangzhou First People’s Hospital, Hangzhou, China
| | - Chang Li
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yu He
- School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China
| | - Huifen Zhou
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Li Yu
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jingwen Chen
- Department of Cardiology, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Shuwei Huang
- Department of Cardiology, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Wei Fu
- Department of Cardiac-Cerebral Diseases, Yinchuan Cardiac-Cerebral Treatment Internet Hospital, Yinchuan, China
| | - Haitong Wan
- Institute of Cardio-cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou, China
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