ASPIRIN RESISTANCE IN NEUROVASCULAR DISEASES.
BACKGROUND
The issue of resistance to antiplatelet therapy has raised many questions in the area of neurovascular diseases. The first objective of this work was to determine the prevalence of aspirin resistance in neurovascular patients with clinical non-responsiveness to aspirin treatment and a high-risk of atherothrombotic complications using two interpretable and independent methods (aggregation and PFA 100). The second objective was to find the correlation between both assays and to evaluate the results in groups at risk for various cerebrovascular diseases.


METHODS
Laboratory tests of aspirin resistance were performed in 79 patients with clinical non-responsiveness to aspirin treatment suffering from neurovascular diseases. Patients were divided into the two groups: expected low risk for aspirin resistance due to the first manifestation of a neurovascular disease (n = 34) and expected high risk due to the second clinical manifestation of a neurovascular disease (n = 45).


RESULTS
The prevalence of aspirin resistance in both groups combined as determined by the PFA-100 and CPG techniques were 50.6% and 17.7%, respectively. No correlation was found between the two techniques.


CONCLUSIONS
No significant prevalence of aspirin resistance was demonstrated by either method despite the heterogeneous pathophysiological mechanisms. However, we are presently unable to provide an accurate opinion on the value of laboratory test result or routine monitoring in clinical neurology.
University Hospital Hradec Králové and Charles University in Prague, Faculty of Medicine in Hradec Králové, Comprehensive Department of Neurology, Stroke Center, Czech Republic. Valismar@seznam.cz.
Martin
M
Vališ
University Hospital Hradec Králové and Charles University in Prague, Faculty of Medicine in Hradec Králové, Comprehensive Department of Neurology, Stroke Center, Czech Republic.
Dagmar
D
Krajíčková
University Hospital Hradec Králové and Charles University in Prague, Faculty of Medicine in Hradec Králové, Department of Internal Medicine, Czech Republic.
Jaroslav
J
Malý
University Hospital Hradec Králové and Charles University in Prague, Faculty of Medicine in Hradec Králové, Department of Internal Medicine, Czech Republic.
Radovan
R
Malý
University Hospital Hradec Králové and Charles University in Prague, Faculty of Medicine in Hradec Králové, Department of Internal Medicine, Czech Republic.
Ilona
I
Fátorová
Department of Computing and Control Engineering, Institute of Chemical Technology, Prague, Czech Republic.
Oldřich
O
Vyšata
University Hospital Hradec Králové and Charles University in Prague, Faculty of Medicine in Hradec Králové, Comprehensive Department of Neurology, Stroke Center, Czech Republic.
Roman
R
Herzig
D000368:Aged; D001241:Aspirin / Q000494:pharmacology*; D002561:Cerebrovascular Disorders / Q000188:drug therapy*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000494:pharmacology*; D015995:Prevalence
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin