title: Can the previous therapeutic control of the main risk factors of cerebrovascular disease influence the acetylsalicylic Acid-nonresponsive status in acute ischemic stroke patients? Results from a portuguese prospective cohort study.
abstract: BACKGROUND
  Acute ischemic stroke (AIS) is a complex disease, and the therapeutic control of its risk factors may influence the efficacy of acetylsalicylic acid (ASA) and the occurrence of new vascular events. The aim of this study was to investigate the potential in vivo properties of a previous treatment controlling the main risk factors of cerebrovascular disease, in the ASA-nonresponsive status in a Portuguese population.
  
  
  METHODS
  We conducted a prospective cohort study with the recruitment of 90 patients diagnosed with AIS and a follow-up protocol was set up with recurrent stroke as the main clinical end point under evaluation. At admission, PFA-100 (platelet function analyzer) test was evaluated in blood samples from AIS patients treated with 100 mg/day of ASA and previously treated with antihypertensive, antidiabetic, or statin drugs.
  
  
  RESULTS
  We observed that 30% of patients were ASA nonresponders. Multivariate regression analysis indicated that the previous treatment with antihypertensive drugs emerged with a significant risk reduction of an ASA-nonresponsive status (odds ratio, .119; 95% confidence interval, .026-.538; P = .006). Furthermore, our results indicated an influence of ASA-nonresponsive status in a decreased period to a new recurrent stroke event in the time frame of 24 months (P = .005, log-rank test).
  
  
  CONCLUSIONS
  ASA is an important part of treatment of AIS, and its efficacy may be improved in previous high-risk cerebrovascular patients, particularly with antihypertensive therapeutic control.
authors: Department of Medicine, Faculty of Medicine of University of Porto, Internal Medicine, Centro Hospitalar São João, Porto, Portugal. Electronic address: m.corisca@gmail.com.
authors: Margarida
authors: M
authors: Freitas-Silva
authors: Department of Blood Transfusion and Blood Bank, Centre of Thrombosis, Hemostasis and Vascular Biology, Centro Hospitalar São João, Porto, Portugal.
authors: Luciana
authors: L
authors: Gonçalves
authors: LPCC Research Department, Portuguese League Against Cancer (NRNorte), Porto, Portugal; CEBIMED, Faculty of Health Sciences of Fernando Pessoa University, Porto, Portugal; ICBAS, Abel Salazar Institute for the Biomedical Sciences, University of Porto, Porto, Portugal.
authors: Rui
authors: R
authors: Medeiros
authors: Department of Medicine, Faculty of Medicine of University of Porto, Internal Medicine, Centro Hospitalar São João, Porto, Portugal.
authors: José Pedro
authors: JP
authors: Nunes
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use*; D002545:Brain Ischemia / Q000188:drug therapy*; D002561:Cerebrovascular Disorders / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011446:Prospective Studies; D020521:Stroke / Q000188:drug therapy; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
keywords: Acute ischemic stroke; acetylsalicylic acid; antidiabetic; antihypertensive; cerebrovascular disease; platelet function