Joon-Tae Kim1, Suk-Hee Heo2, Kang-Ho Choi2, Tai-Seung Nam2, Seong-Min Choi2, Seung-Han Lee2, Man-Seok Park2, Byeong C Kim2, Myeong-Kyu Kim2, Jeffrey L Saver2, Ki-Hyun Cho2. 1. From the Department of Neurology, Chonnam National University Hospital, Gwangju, Korea (J.-T.K., K.-H.C., T.-S.N., S.-M.C., S.-H.L., M.-S.P., B.C.K., M.-K.K., K.-H.C.); Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun, Korea (S.-H.H.); and Stroke Center and Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles (J.L.S.). alldelight2@jnu.ac.kr. 2. From the Department of Neurology, Chonnam National University Hospital, Gwangju, Korea (J.-T.K., K.-H.C., T.-S.N., S.-M.C., S.-H.L., M.-S.P., B.C.K., M.-K.K., K.-H.C.); Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun, Korea (S.-H.H.); and Stroke Center and Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles (J.L.S.).
Abstract
BACKGROUND AND PURPOSE: Time-dependent changes in individual platelet reactivity have been detected in patients with coronary artery disease. Therefore, we sought to evaluate the time-dependent changes in platelet reactivity to aspirin during the acute stage after ischemic stroke and the clinical implications of variable patient responses to aspirin in acute ischemic stroke. METHODS: We conducted a single-center, prospective, observational study. The acute aspirin reaction unit (ARU) was measured after 3 hours of aspirin loading, with higher values indicating increased platelet reactivity despite aspirin therapy. The follow-up ARU was measured on the fifth day of consecutive aspirin intake. The numeric difference between the follow-up ARU and the acute ARU was defined as ΔARU and was stratified into quartiles. Early neurological deterioration was regarded as an early clinical outcome. RESULTS: Both the acute ARU (476±69 IU) and the follow-up ARU (451±68 IU) were measured in 349 patients in this study. Early neurological deterioration was observed in 72 patients (20.6%). Changes in aspirin platelet reactivity over time showed an approximately Gaussian distribution. The highest ΔARU quartile was independently associated with early neurological deterioration (odds ratio, 3.19; 95% confidence interval, 1.43-7.10; P=0.005) by multivariate logistic regression analysis. CONCLUSIONS: The results of our study showed that the increase in platelet reactivity to aspirin over time is independently associated with early neurological deterioration in patients with acute ischemic stroke. In addition, during the acute stage of ischemic stroke, serial platelet reactivity assays may be more useful than a single assay for identifying the clinical implications of aspirin platelet reactivity after ischemic stroke.
BACKGROUND AND PURPOSE: Time-dependent changes in individual platelet reactivity have been detected in patients with coronary artery disease. Therefore, we sought to evaluate the time-dependent changes in platelet reactivity to aspirin during the acute stage after ischemic stroke and the clinical implications of variable patient responses to aspirin in acute ischemic stroke. METHODS: We conducted a single-center, prospective, observational study. The acute aspirin reaction unit (ARU) was measured after 3 hours of aspirin loading, with higher values indicating increased platelet reactivity despite aspirin therapy. The follow-up ARU was measured on the fifth day of consecutive aspirin intake. The numeric difference between the follow-up ARU and the acute ARU was defined as ΔARU and was stratified into quartiles. Early neurological deterioration was regarded as an early clinical outcome. RESULTS: Both the acute ARU (476±69 IU) and the follow-up ARU (451±68 IU) were measured in 349 patients in this study. Early neurological deterioration was observed in 72 patients (20.6%). Changes in aspirin platelet reactivity over time showed an approximately Gaussian distribution. The highest ΔARU quartile was independently associated with early neurological deterioration (odds ratio, 3.19; 95% confidence interval, 1.43-7.10; P=0.005) by multivariate logistic regression analysis. CONCLUSIONS: The results of our study showed that the increase in platelet reactivity to aspirin over time is independently associated with early neurological deterioration in patients with acute ischemic stroke. In addition, during the acute stage of ischemic stroke, serial platelet reactivity assays may be more useful than a single assay for identifying the clinical implications of aspirin platelet reactivity after ischemic stroke.
Authors: Lukasz Milanowski; Justyna Pordzik; Piotr K Janicki; Agnieszka Kaplon-Cieslicka; Marek Rosiak; Michal Peller; Agata Tyminska; Krzysztof Ozieranski; Krzysztof J Filipiak; Grzegorz Opolski; Dagmara Mirowska-Guzel; Marek Postula Journal: Acta Diabetol Date: 2016-12-19 Impact factor: 4.280
Authors: Jurgis Alvikas; Mazen Zenati; Insiyah Campwala; Jan O Jansen; Adnan Hassoune; Heather Phelos; David O Okonkwo; Matthew D Neal Journal: J Trauma Acute Care Surg Date: 2022-01-01 Impact factor: 3.697
Authors: Adam Wiśniewski; Joanna Sikora; Agata Sławińska; Karolina Filipska; Aleksandra Karczmarska-Wódzka; Zbigniew Serafin; Grzegorz Kozera Journal: J Clin Med Date: 2020-01-17 Impact factor: 4.241