Weili Jia1,2,3,4, Qian Jia5,6,7,8, Yumei Zhang1,2,3,4,9, Xingquan Zhao1,2,3,4, Yongjun Wang1,2,3,4. 1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing, 100070, China. 2. China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China. 3. Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100070, China. 4. Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100070, China. 5. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing, 100070, China. jiaqian1616@163.com. 6. China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China. jiaqian1616@163.com. 7. Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100070, China. jiaqian1616@163.com. 8. Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100070, China. jiaqian1616@163.com. 9. Department of rehabilitation medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
Abstract
OBJECTIVE: Diabetes mellitus (DM) had been discovered as an independent risk factor for high on-treatment platelet reactivity (HPR) in patients with ischemic stroke. However, studies on the relationship between prediabetes and the occurrence of HPR remain scarce. This study is aimed at clarifying the association between prediabetes and HPR among patients with recent ischemic stroke or transient ischemic stroke (TIA). METHODS: Patients with ischemic stroke or TIA within 90 days after onset were recruited consecutively. All patients were divided into three groups: DM, prediabetes, and normal glucose tolerance according to fasting glucose, HbA1c, or OGTT. Three months later, all patients were performed platelet aggregation inhibition test and screened for high on-treatment platelet reactivity. The effect of prediabetes on HPR was analyzed in a multivariable logistic regression model. RESULTS: This study recruited 237 patients with ischemic stroke or TIA, including 57 cases with prediabetes, 108 with DM, and 72 with normal glucose tolerance. Aspirin and/or clopidogrel resistance was discovered in 28 cases among prediabetes group, which was significantly more frequent than normal glucose tolerance group(49.1% versus 33.3%, P = 0.046). After adjusting for confounding factors, prediabetes was found as an independent risk factor for high on-treatment platelet reactivity (HPR) among patients with recent ischemic stroke or TIA (odds ratio 2.92; 95% CI, 1.29 to 6.63, P = 0.01). CONCLUSIONS: Prediabetes was an independent risk factor for high on-treatment platelet reactivity in patients with recent ischemic cerebrovascular disease. Patients with prediabetes should be highlighted for the efficacy test of antiplatelet drugs.
OBJECTIVE:Diabetes mellitus (DM) had been discovered as an independent risk factor for high on-treatment platelet reactivity (HPR) in patients with ischemic stroke. However, studies on the relationship between prediabetes and the occurrence of HPR remain scarce. This study is aimed at clarifying the association between prediabetes and HPR among patients with recent ischemic stroke or transient ischemic stroke (TIA). METHODS:Patients with ischemic stroke or TIA within 90 days after onset were recruited consecutively. All patients were divided into three groups: DM, prediabetes, and normal glucose tolerance according to fasting glucose, HbA1c, or OGTT. Three months later, all patients were performed platelet aggregation inhibition test and screened for high on-treatment platelet reactivity. The effect of prediabetes on HPR was analyzed in a multivariable logistic regression model. RESULTS: This study recruited 237 patients with ischemic stroke or TIA, including 57 cases with prediabetes, 108 with DM, and 72 with normal glucose tolerance. Aspirin and/or clopidogrel resistance was discovered in 28 cases among prediabetes group, which was significantly more frequent than normal glucose tolerance group(49.1% versus 33.3%, P = 0.046). After adjusting for confounding factors, prediabetes was found as an independent risk factor for high on-treatment platelet reactivity (HPR) among patients with recent ischemic stroke or TIA (odds ratio 2.92; 95% CI, 1.29 to 6.63, P = 0.01). CONCLUSIONS: Prediabetes was an independent risk factor for high on-treatment platelet reactivity in patients with recent ischemic cerebrovascular disease. Patients with prediabetes should be highlighted for the efficacy test of antiplatelet drugs.
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Keywords:
High on-treatment platelet reactivity (HPR); Ischemic stroke; Prediabetes; TIA