Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.

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Dawn Kleindorfer, MD Associate Professor August 27 th , 2008

Transcript of Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.

Page 1: Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.

Dawn Kleindorfer, MD

Associate Professor

August 27th, 2008

Page 2: Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.

Financial Disclosures Site Principal Investigator, PRoFESS

study, 2004-2008

Speaker’s Bureau, Boehringer IngelheimNon-significant category, per UC guidelines

Member, National Stroke Experts Advisory Panel, Boehringer Ingelheim, 8/08

Page 3: Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.
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Page 6: Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.
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Page 8: Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.
Page 9: Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.
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Page 11: Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.
Page 12: Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.
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Discussion Cases

65yo BF, with HTN, presents with her first ischemic stroke, small vessel subtype.Which antiplatelet at discharge?

72yo WM c HTN, DM, HLD, smoking, presents with his second ischemic stroke, R MCA infarct, on aspirinWhich antiplatelet at discharge?

Page 25: Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.

Bottom Line for Stroke Prevention? Still will be controversial as to which anti-

platelet is first line

PRoFESS showed that aggrenox and plavix are equally effective and both are options

Previous data had shown aggrenox is better than aspirin, and more controversially, that plavix is better than aspirin, PRoFESS doesn’t change that

Page 26: Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.

Bottom Line?

Issues such as patient compliance, financial situation, history of headaches, may need to be factored in for each patient

Don’t forget other risk factors! May make a much larger impact than agonizing over antiplatelets….

Page 27: Dawn Kleindorfer, MD Associate Professor August 27 th, 2008.