期刊
JOURNAL OF CLINICAL NEUROLOGY
卷 18, 期 4, 页码 421-427出版社
KOREAN NEUROLOGICAL ASSOC
DOI: 10.3988/jcn.2022.18.4.421
关键词
recurrent stroke; aspirin resistance; atherosclerosis; embolism; stroke mechanism
资金
- Brain Convergence Research Program of the National Research Foundation (NRF) - Korean government (MSIT) [2020M3E5D2A01084576]
- National Research Foundation of Korea (NRF) - Korean government (MSIT) [2020R1A2C2100077]
- National Research Foundation of Korea [2020R1A2C2100077] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)
Despite the use of antiplatelet agents, high-on-aspirin platelet reactivity (HAPR) can lead to recurrent ischemic stroke, especially in cases of large-artery atherosclerosis. HAPR is more commonly associated with stroke due to extracranial atherosclerosis and inadequate antiplatelet inhibition. Artery-to-artery embolism is independently associated with HAPR in both types of stroke.
Background and Purpose Ischemic stroke recurs despite the use of antiplatelet agents. Various mechanisms are involved in recurrence due to intracranial atherosclerosis (ICAS) and extracranial atherosclerosis (ECAS). High-on-aspirin platelet reactivity (HAPR) may differ between recurrent stroke due to ICAS and ECAS. Methods Patients with recurrent ischemic stroke as a result of large-artery atherosclerosis despite taking aspirin were enrolled consecutively. Ischemic stroke was classified as stroke due to ICAS or ECAS according to the location of the culprit stenosis. An aspirin reaction units (ARU) value of >550 IU was defined as HAPR. HAPR and its associated factors were compared between the two groups and also considering the mechanism of stroke. Results Among the 190 patients with recurrent stroke (111 with ICAS and 79 with ECAS), 36 (18.3%) showed HAPR. The ARU value was higher in the ECAS than the ICAS group (492 +/- 83 vs. 465 +/- 78, mean +/- standard deviation; p=0.028), as was the proportion of patients with HAPR (27.8% vs. 12.6%, p=0.008). Being male and having stroke due to ECAS (reference = stroke due to ICAS: odds ratio=5.760; 95% confidence interval=2.154-15.403; p<0.001) was independently associated with HAPR. The ARU value differed according to the stroke mechanism, and was highest in those with artery-to-artery embolism. Artery-to-artery embolism was independently associated with HAPR in both the ICAS and ECAS groups. Conclusions Recurrent stroke due to ECAS was more strongly associated with HAPR and insufficient antiplatelet inhibition than was that due to ICAS. Artery-to-artery embolism was associated with HAPR in recurrent ischemic stroke as a result of ICAS or ECAS.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据