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Aspirin resistance is associated with increased stroke severity and infarct volume

Authors
Oh, Mi SunYu, Kyung-HoLee, Ju-HunJung, SanKim, ChulhoJang, Min UkLee, JuneyoungLee, Byung-Chul
Issue Date
10-5월-2016
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
NEUROLOGY, v.86, no.19, pp.1808 - 1817
Indexed
SCIE
SCOPUS
Journal Title
NEUROLOGY
Volume
86
Number
19
Start Page
1808
End Page
1817
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/88664
DOI
10.1212/WNL.0000000000002657
ISSN
0028-3878
Abstract
Objectives: To investigate whether aspirin resistance is associated with initial stroke severity and infarct volume, using diffusion-weighted imaging (DWI) in patients with acute ischemic stroke that occurred while taking aspirin. Methods: We studied a total of 310 patients who were admitted within 48 hours of acute ischemic stroke onset. All patients had been taking aspirin for at least 7 days before stroke onset. Aspirin resistance, defined as high residual platelet reactivity (HRPR) on aspirin treatment, was measured using the VerifyNow assay and defined as an aspirin reaction unit >= 550. Initial stroke severity was assessed using the NIH Stroke Scale (NIHSS) score. Infarct volume was measured using DWI. Results: HRPR occurred in 86 patients (27.7%). The initial NIHSS score (median [interquartile range]) was higher in patients with HRPR than in the non-HRPR group (6 [3-15] vs 3 [1-8], p < 0.001). DWI infarct volumes were also larger in the HRPR group compared to the non-HRPR group (5.4 [0.8-43.2] vs 1.7 [0.4-10.3], p = 0.002). A multivariable median regression analysis showed that HRPR was significantly associated with an increase of 2.1 points on the NIHSS (95% confidence interval 0.8-4.0, p < 0.001) and an increase of 2.3 cm(3) in DWI infarct volume (95% confidence interval 0.4-3.9, p < 0.001). Conclusions: Aspirin resistance is associated with an increased risk of severe stroke and large infarct volume in patients taking aspirin before stroke onset.
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