title: The association between high on-treatment platelet reactivity and early recurrence of ischemic events after minor stroke or TIA.
abstract: OBJECTIVE
  To evaluate the role of HTPR in predicting early recurrence of ischemic events in patients with minor ischemic stroke or high-risk TIA.
  
  
  METHODS
  From January 2014 to September 2014, a single center continuously enrolled patients with minor ischemic stroke or high-risk TIA and gave them antiplatelet therapy consisting of aspirin with clopidogrel. HTPR was assessed by TEG after 7 days of antiplatelet therapy and detected CYP2C19 genotype. The incidence of recurrent ischemic events was assessed 3 months after onset. The incidence of recurrent ischemic events was compared between the HTPR and NTPR groups with the Kaplan-Meier method, and multivariate Cox proportional hazards models were used to determine the risk factors associated with recurrent ischemic events.
  
  
  RESULTS
  We enrolled 278 eligible patients with minor ischemic stroke or high-risk TIA. Through TEG testing, patients with HTPR were 22.7%, and carriers were not associated with HTPR to ADP by TEG-ADP(%) (p = 0.193). A total of 265 patients completed 3 months of follow-up, and Kaplan-Meier analysis showed that patients with HTPR had a higher percentage of recurrent ischemic events compared with patients with NTPR (p = 0.002). In multivariate Cox proportional hazards models, history of ischemic stroke or TIA (HR 4.45, 95% CI 1.77-11.16, p = 0.001) and HTPR (HR 3.34, 95% CI 1.41-7.91, p = 0.006) was independently associated with recurrent ischemic events.
  
  
  CONCLUSIONS
  In patients with minor stroke or TIA, the prevalence of HTPR was 22.7%, and HTPR was independently associated with recurrent ischemic events.
authors.affiliation: a Department of Neurology , Tangshan Gongren Hospital , Tangshan , China.
authors.forename: Zilong
authors.initials: Z
authors.lastname: Rao
authors.affiliation: b Department of Neurology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China.|c China National Clinical Research Center for Neurological Diseases , Beijing , China.|d Center of Stroke , Beijing Institute for Brain Disorders , Beijing , China.|e Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease , Beijing , China.
authors.forename: Huaguang
authors.initials: H
authors.lastname: Zheng
authors.affiliation: f Department of Information Engineering , Tangshan Vocational and Technical College , Tangshan , China.
authors.forename: Fei
authors.initials: F
authors.lastname: Wang
authors.affiliation: b Department of Neurology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China.|c China National Clinical Research Center for Neurological Diseases , Beijing , China.|d Center of Stroke , Beijing Institute for Brain Disorders , Beijing , China.|e Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease , Beijing , China.
authors.forename: Anxin
authors.initials: A
authors.lastname: Wang
authors.affiliation: b Department of Neurology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China.|c China National Clinical Research Center for Neurological Diseases , Beijing , China.|d Center of Stroke , Beijing Institute for Brain Disorders , Beijing , China.|e Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease , Beijing , China.
authors.forename: Liping
authors.initials: L
authors.lastname: Liu
authors.affiliation: b Department of Neurology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China.|c China National Clinical Research Center for Neurological Diseases , Beijing , China.|d Center of Stroke , Beijing Institute for Brain Disorders , Beijing , China.|e Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease , Beijing , China.
authors.forename: Kehui
authors.initials: K
authors.lastname: Dong
authors.affiliation: b Department of Neurology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China.|c China National Clinical Research Center for Neurological Diseases , Beijing , China.|d Center of Stroke , Beijing Institute for Brain Disorders , Beijing , China.|e Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease , Beijing , China.
authors.forename: Xingquan
authors.initials: X
authors.lastname: Zhao
authors.affiliation: b Department of Neurology , Beijing Tiantan Hospital, Capital Medical University , Beijing , China.|c China National Clinical Research Center for Neurological Diseases , Beijing , China.|d Center of Stroke , Beijing Institute for Brain Disorders , Beijing , China.|e Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease , Beijing , China.
authors.forename: Yilong
authors.initials: Y
authors.lastname: Wang
authors.affiliation: a Department of Neurology , Tangshan Gongren Hospital , Tangshan , China.
authors.forename: Yibin
authors.initials: Y
authors.lastname: Cao
mesh_terms: D000328:Adult; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D001792:Blood Platelets / Q000473:pathology*; D000077144:Clopidogrel; D065731:Cytochrome P-450 CYP2C19 / Q000235:genetics; D005260:Female; D006801:Humans; D002546:Ischemic Attack, Transient / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015995:Prevalence; D011446:Prospective Studies; D012008:Recurrence; D020521:Stroke / Q000188:drug therapy / Q000473:pathology*; D013916:Thrombelastography; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; C045793:CYP2C19 protein, human; D065731:Cytochrome P-450 CYP2C19; D013988:Ticlopidine; D001241:Aspirin
keywords: Minor ischemic stroke; high on-treatment platelet reactivity; recurrent ischemic events; thromboelastography; transient ischemic attack