Efficacy of Clopidogrel on Incidence of Silent Brain Infarction
Status:
Not yet recruiting
Trial end date:
2025-04-30
Target enrollment:
Participant gender:
Summary
Silent brain infarctions (SBIs) are a manifestation of covert cerebrovascular disease,
without obvious clinical deficit, noted very often in patients presenting with a new stroke
or new transient ischemic attack. SBIs are linked to a significant increase in risk for
subsequent stroke and cognitive decline. However, no biomarker is currently available that
can predict the recurrence of these subclinical lesions. Coated-platelets are a measure of
platelet procoagulant potential significantly increased in patients with ischemic stroke or
transient ischemic attack compared to unaffected controls. Higher coated-platelet levels are
strongly associated with both the presence and number of SBIs. Among medications approved for
preventing stroke recurrence, we identified clopidogrel as a pharmacological agent leading to
a decrease in coated-platelet levels. In this project, we plan to evaluate if clopidogrel can
decrease the rate of occurrence of new silent brain infarctions. The result will enhance the
investigators understanding of the relationship between platelets and silent brain infarcts,
leading to improved health care delivery and also potential targets for novel preventive
pharmacological interventions.