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Aspirin resistant and stroke severity

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https://www.readbyqxmd.com/read/27060166/aspirin-resistance-is-associated-with-increased-stroke-severity-and-infarct-volume
#1
Mi Sun Oh, Kyung-Ho Yu, Ju-Hun Lee, San Jung, Chulho Kim, Min Uk Jang, Juneyoung Lee, Byung-Chul Lee
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...
May 10, 2016: Neurology
https://www.readbyqxmd.com/read/26576697/the-interplay-between-stroke-severity-antiplatelet-use-and-aspirin-resistance-in-ischemic-stroke
#2
Nergiz Agayeva, Mehmet Akif Topcuoglu, Ethem Murat Arsava
BACKGROUND: The issue of whether prior antiplatelet use favorably affects stroke severity is currently unresolved. In this study, we evaluated the effect of antiplatelet use on clinical stroke severity and ischemic lesion volume, and assessed the confounding effect of laboratory-defined aspirin resistance on this relationship. METHODS: Admission National Institutes of Health Stroke Scale (NIHSS) score, ischemic lesion volumes on diffusion-weighted imaging (DWI), and in vitro aspirin resistance, in addition to other pertinent stroke features, were determined in a series of ischemic stroke patients...
February 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/26367525/interest-of-antiplatelet-drug-testing-after-an-acute-ischemic-stroke
#3
Cyrielle Coignion, Mathilde Poli, Sharmila Sagnier, Geneviève Freyburger, Pauline Renou, Sabrina Debruxelles, François Rouanet, Igor Sibon
BACKGROUND: Stroke occurrence despite chronic antiplatelet drug (APD) treatment is frequent. We aimed at evaluating the relevance of platelet aggregation testing in the identification of stroke etiology in this context. METHODS: Patients admitted for a suspected acute ischemic stroke, while under APD (aspirin and/or clopidogrel), were prospectively included. The efficacy of the APD was evaluated using a Multiplate™ assay. Resistance was confirmed using light transmission aggregometry...
2015: European Neurology
https://www.readbyqxmd.com/read/24404131/microfluidic-thrombosis-under-multiple-shear-rates-and-antiplatelet-therapy-doses
#4
Melissa Li, Nathan A Hotaling, David N Ku, Craig R Forest
The mainstay of treatment for thrombosis, the formation of occlusive platelet aggregates that often lead to heart attack and stroke, is antiplatelet therapy. Antiplatelet therapy dosing and resistance are poorly understood, leading to potential incorrect and ineffective dosing. Shear rate is also suspected to play a major role in thrombosis, but instrumentation to measure its influence has been limited by flow conditions, agonist use, and non-systematic and/or non-quantitative studies. In this work we measured occlusion times and thrombus detachment for a range of initial shear rates (500, 1500, 4000, and 10000 s(-1)) and therapy concentrations (0-2...
2014: PloS One
https://www.readbyqxmd.com/read/24211052/aspirin-resistant-patients-with-recent-ischemic-stroke
#5
L Castilla-Guerra, M S Navas-Alcántara, M C Fernández-Moreno
Some patients with a recent ischemic stroke who are being treated with aspirin as an antiaggregant suffer a new ischemic stroke. These patients (15-25%) have been called unresponsive to aspirin or aspirin resistant. The aspirin-resistant patients have a four-time greater risk of suffering a stroke. Furthermore, these strokes are generally more severe, with increased infarct volume and greater risk of recurrence. There is currently no ideal laboratory test to detect the resistance to the antiaggregant effect of aspirin...
April 2014: Revista Clínica Espanõla
https://www.readbyqxmd.com/read/23454623/aspirin-insensitive-thrombophilia-transcript-profiling-of-blood-identifies-platelet-abnormalities-and-hla-restriction
#6
Payam Fallahi, Richard Katz, Ian Toma, Ranyang Li, Jonathan Reiner, Kiersten VanHouten, Larry Carpio, Lorraine Marshall, Yi Lian, Sujata Bupp, Sidney W Fu, Frederick Rickles, David Leitenberg, Yinglei Lai, Babette B Weksler, Frederik Rebling, Zhaoqing Yang, Timothy A McCaffrey
Aspirin is the most widely used antiplatelet agent because it is safe, efficient, and inexpensive. However, a significant subset of patients does not exhibit a full inhibition of platelet aggregation, termed 'aspirin resistance' (AR). Several major studies have observed that AR patients have a 4-fold increased risk of myocardial infarction (MI), stroke, and other thrombotic events. Arachidonic acid-stimulated whole blood aggregation was tested in 132 adults at risk for ischemic events, and identified an inadequate response to aspirin therapy in 9 patients (6...
May 15, 2013: Gene
https://www.readbyqxmd.com/read/23165316/association-of-aspirin-resistance-with-increased-stroke-severity-and-infarct-size
#7
Amy S Y Zheng, Leonid Churilov, Ruth E Colley, Christine Goh, Stephen M Davis, Bernard Yan
OBJECTIVE: To investigate the relationship between aspirin resistance and clinical and neuroimaging measures of stroke severity in acute stroke patients. DESIGN: Prospective single-center survey of acute ischemic stroke patients receiving aspirin therapy. SETTING: The Royal Melbourne Hospital, Parkville, Victoria, Australia. PATIENTS: Ninety acute stroke patients who previously received aspirin therapy were enrolled...
February 2013: JAMA Neurology
https://www.readbyqxmd.com/read/23069275/clinical-and-biochemical-aspirin-resistance-in-patients-with-recurrent-cerebral-ischemia
#8
Ashraf El-Mitwalli, Hanan Azzam, Mohammad Abu-Hegazy, Mohamed Gomaa, Yasser Wasel
BACKGROUND AND AIM: Stroke recurrence is an important public health concern. One half of survivors remain disabled, and one seventh requires institutional care. Aspirin remains the cornerstone of primary and secondary stroke prevention; meanwhile, aspirin resistance is one of the possible causes of stroke recurrence. We aimed to evaluate the clinical and biochemical aspirin resistance in patients with recurrent ischemic stroke. PATIENTS AND METHODS: We studied demographic characteristics, vascular risk factors, stroke subtypes, radiologic findings and biochemical aspirin resistance tests using both arachidonic acid (AA) and adenosine diphosphate (ADP)-induced light transmittance aggregometry (LTA) on admission and 24h after observed aspirin ingestion...
July 2013: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/21985542/update-on-selecting-and-adjusting-antiplatelet-therapy-for-prevention-of-noncardiogenic-recurrent-ischemic-stroke
#9
REVIEW
Helmi Lutsep
Antiplatelet therapy is a cornerstone of secondary prevention in patients with prior stroke or transient ischemic attack. Recent clinical trials and subanalyses of previous trials have influenced the selection of antiplatelet agents. Clinical decisions regarding the use of antiplatelet therapies have also been affected by recent advancements in our understanding of drug action, metabolism and drug-drug interactions. Aspirin has an established role in secondary prevention of stroke, although some patients are unable to tolerate it and others are resistant to its antiplatelet effects...
October 2011: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/21950643/new-and-emerging-anticoagulant-therapy-for-atrial-fibrillation-and-acute-coronary-syndrome
#10
REVIEW
Estella M Davis, Kathleen A Packard, Jon T Knezevich, Jennifer A Campbell
Abstract Thrombosis is an underlying cause of many cardiovascular disorders, and generation of thrombi in the arterial circulation can lead to unstable angina, myocardial infarction, or ischemic stroke. Antithrombotic therapy is widely used, with proven benefit to prevent ischemic stroke and thromboembolic events in patients with atrial fibrillation (AF) or to prevent further ischemic complications in patients with acute coronary syndrome (ACS). Traditional anticoagulants (including unfractionated heparin, low-molecular-weight heparin, and warfarin) and antiplatelet agents (including aspirin, clopidogrel, and prasugrel) are typically used for these indications...
October 2011: Pharmacotherapy
https://www.readbyqxmd.com/read/21836064/fibrin-clot-structure-and-function-a-role-in-the-pathophysiology-of-arterial-and-venous-thromboembolic-diseases
#11
REVIEW
Anetta Undas, Robert A S Ariëns
The formation of fibrin clots that are relatively resistant to lysis represents the final step in blood coagulation. We discuss the genetic and environmental regulators of fibrin structure in relation to thrombotic disease. In addition, we discuss the implications of fibrin structure for treatment of thrombosis. Fibrin clots composed of compact, highly branched networks with thin fibers are resistant to lysis. Altered fibrin structure has consistently been reported in patients with several diseases complicated by thromboembolic events, including patients with acute or prior myocardial infarction, ischemic stroke, and venous thromboembolism...
December 2011: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/21742104/polymorphisms-associated-with-in-vitro-aspirin-resistance-are-not-associated-with-clinical-outcomes-in-patients-with-coronary-artery-disease-who-report-regular-aspirin-use
#12
COMPARATIVE STUDY
Deepak Voora, John Horton, Svati H Shah, Linda K Shaw, L Kristin Newby
BACKGROUND: We hypothesized that single-nucleotide polymorphisms (SNPs) associated with heightened in vitro platelet function during aspirin exposure (which we define as "laboratory aspirin resistance") would be associated with greater risk for death, myocardial infarction (MI) or stroke among patients with coronary artery disease regularly using aspirin. METHODS: Duke Databank for Cardiovascular Disease patients with (n = 3,449, CATHeterization GENetics cohort) or without (n = 11,754, nongenetic cohort) banked DNA with ≥1 coronary stenosis >75% were followed up at 6 months, then annually for death, MI, or stroke occurring during periods of reported aspirin use...
July 2011: American Heart Journal
https://www.readbyqxmd.com/read/21145162/aspirin-non-responder-status-and-early-neurological-deterioration-a-prospective-study
#13
Jean-Marc Bugnicourt, Bertrand Roussel, Pierre-Yves Garcia, Sandrine Canaple, Chantal Lamy, Olivier Godefroy
OBJECTIVES: In acute ischemic stroke, early neurological deterioration (END) has a severe impact on patient outcome. We tested the hypothesis that initial biological aspirin non-responder status (ANRS) helps predict END. METHODS: A total of 85 patients with acute ischemic stroke on 160mg aspirin daily were prospectively included. END was defined as an increase in the National Institutes of Health Stroke Scale (NIHSS) ≥4 points in the first 72h after admission...
April 2011: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/20738445/controversies-and-future-perspectives-of-antiplatelet-therapy-in-secondary-stroke-prevention
#14
REVIEW
Ralph Weber, Hans-Christoph Diener
Antiplatelet agents are a cornerstone in the treatment of acute arterial thrombotic events and in the prevention of thrombus formation. However, existing antiplatelet agents (mainly aspirin, the combination of aspirin and dipyridamole and clopidogrel) reduce the risk of vascular events only by about one quarter compared with placebo. As a consequence, more efficacious antiplatelet therapies with a reduced bleeding risk are needed. We give an overview of several new antiplatelet agents that are currently investigated in secondary stroke prevention: adenosine 5'-diphosphonate receptor antagonists, cilostazol, sarpogrelate, terutroban and SCH 530348...
October 2010: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/19641662/aspirin-resistance-a-fact-or-a-myth
#15
Gundu Hr Rao
Blood platelets play a very important role in the pathogenesis of heart attacks and stroke. Therefore, several million individuals all over the world take aspirin, an irreversible inhibitor of the cyclooxygenase enzyme, for the prevention of heart attacks and stroke. Over the past three decades, the author's laboratory has used arachidonic acid-induced platelet aggregation as a standard to monitor aspirin sensitivity. However, there has been no detection of a significant number of nonresponders to the action of aspirin in the normal population...
2005: Experimental and Clinical Cardiology
https://www.readbyqxmd.com/read/19452405/platelet-function-and-response-to-aspirin-gender-specific-features-and-implications-for-female-thrombotic-risk-and-management
#16
REVIEW
Christine S Zuern, Stephan Lindemann, Meinrad Gawaz
This article reviews gender-specific differences in platelet function and response to aspirin. In contrast with men, women under 65 years of age do not benefit from aspirin therapy in primary prevention of coronary artery disease. Furthermore, the overall mortality after myocardial infarction is higher among women, which cannot simply be explained by age or individual treatment. Platelets play a central role in thrombo-ischemic events leading to myocardial infarction and ischemic stroke. Gender differences in platelet reactivity and "aspirin resistance" have been reported...
April 2009: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/19214167/plasma-midregional-pro-atrial-natriuretic-peptide-is-associated-with-blood-pressure-indices-and-hypertension-severity-in-adults-with-hypertension
#17
MULTICENTER STUDY
Mahyar Khaleghi, Umer Saleem, Nils G Morgenthaler, Stephen T Turner, Andreas Bergmann, Joachim Struck, Thomas H Mosley, Iftikhar J Kullo
BACKGROUND: Midregional pro-atrial natriuretic peptide (MR-proANP) is a newly described stable fragment of the N-terminal part of pro-atrial natriuretic peptide. We tested the hypothesis that in adults with essential hypertension, plasma levels of MR-proANP would be associated with systolic blood pressure (SBP), pulse pressure, and hypertension severity. METHODS: Participants included 1,034 African Americans (65 +/- 9 years, 72% women) and 880 non-Hispanic whites (61 +/- 9 years, 55% women) belonging to sibships ascertained on the basis of hypertension...
April 2009: American Journal of Hypertension
https://www.readbyqxmd.com/read/18855644/clopidogrel-and-aspirin-in-cardiovascular-medicine-responders-or-not-current-best-available-evidence
#18
REVIEW
C E Tourmousoglou, C K Rokkas
Dual antiplatelet therapy represents an important advance for patients with established coronary artery disease. It is an important strategy for patients with acute coronary syndromes and those undergoing percutaneous transcatheter coronary interventions. Clopidogrel effectively inhibits ADP-induced platelet activation and aggregation by selectively and irreversibly blocking the P2Y(12) receptor on the platelet membrane. Aspirin works by irreversibly acetylating the cyclooxygenase (COX-1) enzyme, thus suppressing the production of thromboxane A(2) (TxA(2)) and inhibiting platelet activation and aggregation...
October 2008: Cardiovascular & Hematological Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/18346650/baseline-characteristics-of-patients-with-acute-ischemic-stroke-in-a-suburban-area-of-thailand
#19
Pornpatr Dharmasaroja
BACKGROUND: Development in stroke care during the past two decades has greatly reduced mortality and dependence in many developed countries. However, we still lack information about baseline characteristics of patients with ischemic stroke in Thailand, especially in suburban areas. OBJECTIVE: We sought to study characteristics of Thai patients with ischemic stroke, including carotid stenosis and aspirin nonresponders. METHODS: In this preliminary study, we included all patients with acute/subacute ischemic stroke/transient ischemic attack from August 2006 to July 2007...
March 2008: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/18319729/aspirin-resistance-is-more-common-in-lacunar-strokes-than-embolic-strokes-and-is-related-to-stroke-severity
#20
Nicola A Englyst, Gill Horsfield, Joseph Kwan, Christopher D Byrne
The aim of this study was to investigate the relationship between aspirin resistance, ischaemic stroke subtype, stroke severity, and inflammatory cytokines. Aspirin resistance was assessed by thrombelastography in 45 people with ischaemic stroke and 25 controls. Plasma interleukin (IL)-6 was measured. Stroke severity was assessed using the modified Rankin scale and National Institute of Health Stroke Score within 72 h of stroke. Aspirin resistance was more common in the stroke than the control group (67% versus 40%, P=0...
June 2008: Journal of Cerebral Blood Flow and Metabolism
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