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Old 10-27-2011, 04:16 AM   #1
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Triple Antiplatelet Therapy

Hi there
My dear old dad suffered an Ischaemic stroke on Monday and was administered Alteplase treatment within 4 hours of the onset of his stroke. This appeared to work OK, however the hospital have now asked my dad whether he would like to participate in the TARDIS trial - that is the Triple Antiplatelet for Reducing Dependency after Ischaemic Stroke.

Basically they are looking to reduce the possibility of reoccurrence (a further stroke) by thinning the patient's blood - or making it less sticky, and therefore preventing the possibility of further clots - however I am worried at the possible side effects of this trial. Usually the medics will prescribe a course of Aspirin & Dipyridamole, or Aspirin & Clopidogrel, however they are trialling a 35-day course of all three drugs taken together, as they think this may be better than taking the 2 drugs. Obviously adding another drug to the 'cocktail' as it were increases the risks, primarily further bleeding which can prove fatal.

I just wondered whether anybody had any experience of this Triple Antiplatelet therapy and whether they could afford me any advice, as naturally I am very worried at the possible risks involved; a quick google search returned a report from 2008 conducted by Nottingham University (UK) and the conclusion was not very positive at all, however the hospital where my dad is based have told us the trials they have conducted to date have all been very positive. Unfortunately they have not (yet) given us any figures to back this up, but I do know that to-date the trial has been run on c550 patients UK-wide, and will be rolled out worldwide to a further 4,500 patients.

Any help or advice would be greatly appreciated...

Thanks

 
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Old 10-27-2011, 12:08 PM   #2
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Re: Triple Antiplatelet Therapy

Hi Robefc,
I am sorry about your father's stroke. This is the first time I have heard of TARDIS. I had a stroke in Jan. 2010, so I will only give you my opinion. I personally am leery of new trials and medications. A lot of the time any side-effects some times don't show up for years and it always seems like there is some kind of side-effect eventually. After my stroke my doctor only prescribed me aspirin (325 mg) omega 3 fish oil and folic acid for my blood and circulation along with a Lisinopril (40 mg) for blood pressure and I haven't had another major stroke since then. My doctor seemed to think that aspirin was as good as any other medication out there for blood thinners. So I guess my only question would be why are they adding these other drugs with aspirin?

I know this will probably be your decision because your father may not be able to make that decision for himself. I still let my wife make all of my medical decisions for me since my stroke. I am not trying to tell you one way or the other. I am only giving you my own experience and opinion since my stroke. I do wish you and you father the best for sure. I would like to know what you decide, and I will be behind you whatever you decide. I know this is a trying time for you father by also with the whole family as well.
God Bless,
Tim

Last edited by Positive Cynic; 10-27-2011 at 12:11 PM.

 
Old 10-27-2011, 12:46 PM   #3
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Re: Triple Antiplatelet Therapy

Hi Tim
Thanks very much for your reply. Sorry to hear about your stroke first of all. If you don't mind me asking, how do you feel your quality of life has changed since the stroke?

My dad has always prided himself on being a very self-sufficient man; he's always done everything for himself apart from cooking & cleaning which my dear old mum takes care of. The stroke has come as a huge shock more on a mental level than a physical level; although of course he is suffering physically also. His speech has been affected as you would expect, although there has been a small improvement since the stroke occurred on Monday, and he is also unable to use his left hand. I think this, allied to the need to now learn to co-ordinate and feed himself again, is what is causing him the greatest frustration.

I guess this new trial is because they have run trials on prescribing Aspirin with Dipyridamole, which they think is more successful in the prevention of re-occurrence than just Aspirin on it's own, and so think that adding Clopidogrel - which is sometimes used as an alternative to Aspirin and Dipyridamole because it is just as effective and more cost-effective - may show further signs of improvement. They have told us that in the (worryingly limited) number of trials they've run so far, that this has been the case, and there have been no ill side-effects reported. The aim of the triple antiplatelet is to not just thin the blood but also make it 'less sticky' (sorry, I've forgotten the medical term for this!), hence the introduction of both Dipyridamole/Clopidogrel which apparently act as agents in achieving this.

My dad was deemed to be sufficiently capable to decide for himself and agreed to the trial, however we were given very little notification so were naturally very worried, especially after searching the Internet for further information, upon which we discovered a previous trial run a few years ago, results were particularly negative.

Thanks for your thoughts - much appreciated!

Take care

R

 
Old 10-27-2011, 02:21 PM   #4
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Re: Triple Antiplatelet Therapy

R,
Hello again. I want to respond in detail about your questions about life after a stroke. I have many things I would like to say, but I don't have the time right now. I will try to write back in a day or two. In the mean time, let your father know that his frustration is very normal and he may have many emotions that are new to him, but they are all normal. Most stroke survivors first question to their own self is "am I going crazy?" And I can answer that he is not crazy or going crazy. I hope to tell you more soon. In the mean time, also be positive about the whole situation when talking to him and the other question is that he is not going to be like this the rest of his life (how ever he is right now). Take care and God Bless.
Tim

 
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