Biochemical aspirin resistance and recurrent lesions in patients with acute ischemic stroke.
BACKGROUND
The effect of biochemical aspirin resistance (BAR) on ischemic stroke has not been well established. Early recurrent ischemic lesions (ERILs) on diffusion-weighted imaging (DWI) are proposed as potential surrogate markers of clinically recurrent stroke.


METHODS
We included 117 consecutive patients who (1) were admitted within 24 h of symptom onset; (2) had an ischemic stroke confirmed by DWI; (3) underwent follow-up DWI within seven days after onset, and (4) received aspirin treatment. BAR was measured using the VerifyNow(R) Aspirin Assay. We analyzed the associations between BAR and any ERILs (overall ERILs), and between BAR and ERILs occurring outside the vascular territories of index stroke (distant ERILs).


RESULTS
BAR was observed in 16 (13.7%) patients. Overall ERILs were detected in 34 (29.1%), and distant ERILs in 10 (8.5%) patients. Patients with BAR were more likely to develop ERILs, but the association was not significant (OR 2.13; 95% CI 0.72-6.29; p = 0.234). However, BAR was independently related to distant ERILs by logistic regression analysis (OR 6.01; 95% CI 1.29-28.09; p = 0.023).


CONCLUSIONS
BAR was associated with distant ERILs but not with overall ERILs during the first week after ischemic stroke.
Jeon
Sang-Beom
SB
Stroke Center and Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Song
Ha-Sup
HS
Kim
Bum Joon
BJ
Kim
Hye-Jin
HJ
Kang
Dong-Wha
DW
Kim
Jong S
JS
Kwon
Sun U
SU
D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001241:Aspirin