Aspirin resistance is associated with increased stroke severity and infarct volume

Mi Sun Oh, Kyung Ho Yu, Ju Hun Lee, San Jung, Chulho Kim, Min Uk Jang, Juneyoung Lee, Byung Chul Lee

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1808-1817
Number of pages10
JournalNeurology
Volume86
Issue number19
DOIs
Publication statusPublished - 2016 May 10

ASJC Scopus subject areas

  • Clinical Neurology

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