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- Title
Correlation between Frequency of Microembolic Signals and Efficacy of Antiplatelet Therapy in Symptomatic Carotid Disease.
- Authors
Kerasnoudis, Antonios; Meves, Saskia H.; Gold, Ralf; Krogias, Christos
- Abstract
ABSTRACT BACKGROUND AND PURPOSE The detection of microembolic signals in transcranial-Doppler monitoring is associated with a higher stroke risk. We investigated the correlation between the frequency of microembolic signals and the efficacy of the antiplatelet therapy in patients with a recent symptomatic carotid-artery stenosis. SUBJECTS AND METHODS Thirty-two patients (mean age: 70 years, 22 men) with a recent symptomatic carotid-artery stenosis underwent 30-minute TCD-monitoring. Twenty-three patients received acetylsalicylic-acid and 9 patients clopidogrel as antiplatelet-therapy. At the same day, the antiplatelet effect was measured with multiple-electrode-impedance aggregometry. RESULTS In 20 cases, the qualifying event was a stroke and in 12 cases, a TIA. Twenty-six of the patients had a >50% degree of stenosis. More than one microembolic signals were detected in 13 (40.6%) of the subjects, while multiple-electrode-impedance aggregometry revealed eight low responders (6 acetylsalicylic-acid, 2 clopidogrel). More than one microembolic signals were detected in 6 of the 8 (75.0%) patients with low response, but in only 7 of the 24 subjects (29.2%) with an effective antiplatelet treatment (sensitivity 75%, specificity 70.8%; Fisher's exact test: P = .038). CONCLUSIONS Our study suggests that in patients with recent symptomatic carotid-artery stenosis the detection of more than one microembolic signals might serve as a useful marker for the effectiveness of the antiplatelet treatment.
- Subjects
CAROTID artery diseases; DOPPLER echocardiography; PLATELET aggregation inhibitors; EMBOLISMS; STROKE risk factors; CORONARY artery stenosis; PATIENTS
- Publication
Journal of Neuroimaging, 2013, Vol 23, Issue 4, p484
- ISSN
1051-2284
- Publication type
Article
- DOI
10.1111/j.1552-6569.2012.00770.x