In vitro aspirin resistance and predictors among stroke patients

Abstract

AIM: Aspirin has a widespread usage for the secondary prophylaxis of ischemic cerebrovascular diseases with proven efficacy. However, 10-20% of the patients experience a second stroke while using aspirin. The unsuccessful inhibition of platelet activation induced by cyclo-oxygenase is described as aspirin resistance. In this study, we aimed to demonstrate the incidence of aspirin resistance among cerebrovascular patients and the clinical factors correlated. PATIENTS AND METHOD: The results of whole blood impedance aggregometry tests of 154 patients with cerebrovascular disease were examined at the beginning of the aspirin treatment. In vitro platelet function is tested by using multiplate analyser. Any correlation between age, gender and the presence of hypertension, diabetes, hyperlipidemia, coronary heart disease, atrial fibrillation and smoking was investigated. RESULTS: Seven of the 154 patients had aspirin resistance (4,5%). No statistically significant correlation was observed between aspirin resistance and any of the clinical parameters investigated. CONCLUSION: Aspirin resistance is rare among stroke patients in contrast with the published literature. Multiplate analyser may be efficacious to determine the aspirin resistance. According to the published data untill today, the unanswered questions were the clinical significance of the aspirin resistance and what kind of antithrombotic medications should be preferred for patients with aspirin resistance.