to determine platelet inhibition with our dosing protocol and its relationship to complications and outcomes.
- Abciximab (ReoPro®)Drug
Intervention Desc: Intravenous platelet aggregation inhibitor, monoclonal antibody directed against the platelet glycoprotein GP IIb-IIIa receptor
- Heparin (acute stroke) Drug
Intervention Desc: Intravenous anticoagulant.
Abciximab treatment protocol: Following informed consent, an IV abciximab bolus dose of 0.2mg/kg (max of 16 mg) and infusion dose of 0.05ug/kg/min over 12 hours (max of 2.9 mg over 12 hours) resulting in a maximal dose ~70% of AbESTT-II. Heparin is administered as a 35U/Kg bolus (max: 2500 U) followed by infusion of 17 U/Kg/hr, dose changes are determined by a computerized algorithm with a treatment duration goal of 36 hours.Platelet Function Testing with Verify Now™: Platelet aggregation units are obtained before treatment and 10-20 minutes after abciximab bolus.
|Type||Measure||Time Frame||Safety Issue|
|Primary||Percentage of patients who achieve good outcome at 3 months in terms of reduction in NIHSS of at least 4 or achieving an mRS of 0-2 will be computed based on platelet inhibition and between group comparisons.|
|Secondary||Secondary analysis will involve platelet inhibition along with baseline NIHSS, age, glucose and time to treatment as independent variables for stepwise regression with good outcome on dichotomized scales (eg: mRS 0-2), hemorrhage and mortality as dependant variables.|