title: Searching for factors associated with resistance to acetylsalicylic acid used for secondary prevention of stroke.
abstract: BACKGROUND
  The aim of the study was to evaluate the prevalence of resistance to acetylsalicylic acid (ASA), used for secondary prevention of stroke, including the assessment of risk factors associated with the lack of ASA anti-aggregatory action.
  
  
  METHODS
  Patients after a transient ischaemic attack (TIA) or ischaemic stroke in the acute (n = 111) and chronic phase (n = 87) were enrolled in the study. The assessment of platelet function was performed by whole blood impedance aggregometry using a multi-channel platelet function analyser (Multiplate).
  
  
  RESULTS
  A proper response to ASA was found in 121 patients (61.1%) (ASA responders), a partial response to ASA in 59 patients (29.8%) (ASA partial responders), and ASA resistance in 18 patients (9.1%) (ASA non-responders). Acetylsalicylic acid resistance was observed more frequently in the chronic phase. The mean low-density lipoprotein (LDL) concentration was higher in ASA non-responders (p = 0.02). The mean heart rate (p = 0.03) and the mean haematocrit (p = 0.03) were higher in the group of ASA partial responders and ASA non-responders. Angiotensin II receptor antagonists were more often used in the group of ASA partial responders and ASA non-responders (p = 0.04). Diuretics were more rarely used by ASA non-responders, whereas fibrates were more rarely used by ASA partial responders.
  
  
  CONCLUSIONS
  The method enabled the detection of ASA resistance in some patients with cerebrovascular disease. The study revealed some possible risk factors of ASA resistance: long ASA therapy, increased heart rate, higher LDL concentration, and higher haematocrit value. The relationship between the effect of ASA and other medications (angiotensin II receptor blockers, fibrates, diuretics) requires further study. Platelet function monitoring should be considered in patients at a greater risk of ASA resistance.
authors: Chair and Clinical Department of Neurology in Zabrze, Medical University of Silesia, Katowice, Poland.
authors: Beata
authors: B
authors: Łabuz-Roszak
authors: Chair and Clinical Department of Neurology in Zabrze, Medical University of Silesia, Katowice, Poland.
authors: Krystyna
authors: K
authors: Pierzchała
authors: Department of Biostatistics, Faculty of Public Health, Medical University of Silesia, Katowice, Poland.
authors: Ewa
authors: E
authors: Niewiadomska
authors: Department of Biostatistics, Faculty of Public Health, Medical University of Silesia, Katowice, Poland.
authors: Michał
authors: M
authors: Skrzypek
authors: Chair and Clinical Department of Neurology in Zabrze, Medical University of Silesia, Katowice, Poland.
authors: Agnieszka
authors: A
authors: Machowska-Majchrzak
keywords: acetylsalicylic acid; impedance aggregometry; resistance to acetylsalicylic acid; stroke