10 Nov Combination Clopidogrel Plus Aspirin Better For Post ASD Repair Migraines

Posted at 04:01h in Author Interviews, Heart Disease, Pharmacology by

Josep Rodés-Cabau, MD Director, Catheterization and Interventional Laboratories Quebec Heart and Lung Institute Professor, Faculty of Medicine, Laval University Quebec City, Quebec, CanadaMedicalResearch.com Interview with:
Josep Rodés-Cabau, MD
Director, Catheterization and Interventional Laboratories
Quebec Heart and Lung Institute
Professor, Faculty of Medicine, Laval University
Quebec City, Quebec, Canada

Medical Research: What is the background for this study? What are the main findings?

Dr. Rodés-Cabau: The occurrence of new-onset migraine attacks has been reported in about 15% of patients following transcatheter atrial septal defect (ASD) closure. Prior observational studies suggested a reduction of migraine headache post-ASD closure with the use of clopidogrel on top of aspirin.

Our study (the prospective randomized CANOA trial) showed that the use of clopidogrel (in addition to aspirin) following transcatheter ASD closure was associated with a significant reduction in the occurrence and number of new-onset migraine attacks within the 3 months following the procedure. Also, among patients with migraine attacks, those receiving clopidogrel therapy experience less-severe migraine attacks.

Medical Research: What should clinicians and patients take away from your report?

Dr. Josep Rodés-Cabau: These results have an important clinical impact on the management of patients undergoing transcatheter ASD closure. Also, they may be considered when analyzing or designing the results of past, current, and future studies assessing the efficacy of interatrial shunt closure for the treatment of migraines. Finally, these results provide further insight into the mechanisms of migraine, highlighting the potential role of prothrombotic status on the pathogenesis of migraine in certain groups of patients.

Medical Research: What recommendations do you have for future research as a result of this study?

Dr. Josep Rodés-Cabau:  

  • First, we need longer-term follow-up studies in order to determine the transient vs permanent behavior of new-onset migraine headaches after transcatheter ASD closure.
  • Second, we need to evaluate the optimal duration of clopidogrel therapy after ASD closure, and whether or not the effects of clopidogrel on migraine headaches are a class effect or specific to that medication.
  • Finally, it may be interesting to determine the effects of clopidogrel in patients with migraine and interatrial shunts.

Citation:

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Josep Rodés-Cabau, MD (2015). Combination Clopidogrel Plus Aspirin Better For Post ASD Repair Migraines 

Last Updated on November 10, 2015 by Marie Benz MD FAAD

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