This double-blind pilot study observed the effects of a twenty-one day oral ticlopidine treatment (250 mg/twice daily) on the neurologic outcome and the hemorheologic pattern of 15 patients and 15 placebo-treated controls. Patients and controls (age range sixty-six to eighty-six years) were included in the study within twelve hours of the onset of ischemic stroke, confirmed clinically and by computerized tomography. Scores on Hachinski's Scale and the following he morheologic parameters were monitored weekly for twenty-one days: fibrino gen levels, the whole blood, unfractionated white and red blood cell filterability rates (through 5-micron-pore-diameter filters using a constant-flow positive- pressure system), and the leukocyte count and activation (by microscopic obser vation). The results showed treatment with ticlopidine improved the neurologic outcome (Hachinski's Score +36%, p < 0.03) slightly but significantly (p < 0.001) increased the average values of the whole blood (+ 19%) and red cell (+ 17%) filterability rates and decreased fibrinogen levels (-17%).
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References
1.
Lowe Gdo: Blood rheology in arterial disease. Clin Sci71:137-146, 1986.
2.
Forconi S., Pieragalli D., Guerrini M., et al: Hemorheology and peripheral arterial diseases. Clin Hemorheol7:145-158, 1987.
3.
Kenny MW, Meakir M., Stuart J.: Measurement of erythrocyte filterability using washed-erythrocyte and whole blood methods. Clin Hemorheol1:135-146, 1981.
4.
Ehrly AM, Kohler HJ: Altered deformability of erythrocytes from patients with chronic occlusive arterial disease. Vasa5:319-322, 1976.
5.
Irwin ST, Rocks MJ, McGuigan JA, et al: Effect of reconstructive vascular surgery on red cell deformability—preliminary results. J Clin Pathol36:1136-1139, 1983 .
6.
Lichtman MA, Heal J., Rowe JM: Hyperleukocytic leukaemia: Rheological and clinical features and management. Bailliere'sClin Haematol1:725-746, 1987.
7.
Alderman MJ, Ridge A., Morley AA, et al: Effect of total leukocyte count on whole blood filterability in patients with peripheral vascular disease. J Clin Pathol34:163-166, 1981.
8.
Lowe Gdo, Jaap AJ, Forbes CD: Relation of atrial fibrillation and high hematocrit to mortality in acute stroke. Lancet1:784-786, 1983.
9.
Gaehtgens P.: Deformation and activation of leukocytes—two contradictory phenomena? In: White Cell Mechanics: Basic Science and Clinical Aspects , ed. by Meiselman HJ, Lichtman MA, LaCelle PL.New York: AR Liss, 1984, pp 159-165.
10.
Lowe Gdo: Blood rheology in vitro and in vivo. Bailliere'sClin Haematol1:597-636, 1987.
11.
Ashida S., Abiko Y.: Inhibition of platelet aggregation by a new agent, ticlopidine. Thromb Haemostasis40:542-550, 1979.
12.
Solvay H., Kahn M., Garreyn S., et al: Glucose and erythrocyte ATP: Distinctive effects of dipyridamole and of ticlopidine. Angiology38:815-823, 1987.
13.
Conard J., Lecrubier C, Scarabin, et al: Effects of long term administration of ticlopidine on platelet function and haemostatic variables. Thromb Res20:143-148, 1980.
Mancini G., Carbonara AD, Haremans JF: Immunochemical quantitation of antigens by single radial immunodiffusion. Immunochemistry2:235-240, 1965.
16.
Nash GB, Jones JG, Mikita J., et al: Effects of preparative procedures and of cell activation on flow of white cells through micropore filters. Br J Haematol70:171-176, 1988.
17.
Mikita J., Nash G., Dormandy J.: A simple method of preparing white blood cells for filterability testing. Clin Hemorheol6:635-639, 1986.
18.
Lennie SE, Lowe Gdo, Barbanel JC, et al: Filterability of white blood cell subpopulations, separated by an improved method. Clin Haemorheol7:811-816, 1987.
19.
Ciuffetti G. , Balendra R., Lennie SE, et al: Impaired white blood cell filterability in acute cerebral infarction. Br Med J (in press).
