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    KCI등재후보 SCIE SCOPUS

    Aspirin Resistance May Not Be Associated with Clinical Outcome after Acute Ischemic Stroke: Comparison with Three Different Platelet Function Assays

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    https://www.riss.kr/link?id=A101607790

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    다국어 초록 (Multilingual Abstract) kakao i 다국어 번역

    Background: Aspirin resistance (AR) in platelet function assays showed substantial variation depending on the methods used to evaluate it. Methods: In this study, we prospectively compared the results of Multiplate impedance platelet aggregometry (IPA) with those of light transmission aggregometry (LTA) and VerifyNow® system in determination of the prevalence of aspirin resistance (AR) and investigated the correlation between its presence and poor outcome (modifi ed Rankin scale >2) in 105patients with aspirin after acute ischemic stroke (AIS). Results: After 5 days of using aspirin, 15 patients (14.3%) were classifi ed as aspirin-resistance with the use of IPA, 24 patients (22.9%) by the LTA, and 14 patients (13.3%) by VerifyNow. Good agreement between the results of IPA and VerifyNow, was found (R=0.674, P <0.01). The concordance rate of AR detection was high between VerifyNow and IPA (k=0.72, P <0.01), albeit quite low between LTA and IPA. Regarding on its infl uence on clinical outcome after AIS, there wasn’t any signifi cant relationship between occurrence of poor outcome and the presence of AR in three platelet function assays. Conclusion: This study reveals that the incidence of AR in AIS might be highly test-specifi c. IPA seems to be similar to VerifyNow as a platelet function test.
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    Background: Aspirin resistance (AR) in platelet function assays showed substantial variation depending on the methods used to evaluate it. Methods: In this study, we prospectively compared the results of Multiplate impedance platelet aggregometry (IPA...

    Background: Aspirin resistance (AR) in platelet function assays showed substantial variation depending on the methods used to evaluate it. Methods: In this study, we prospectively compared the results of Multiplate impedance platelet aggregometry (IPA) with those of light transmission aggregometry (LTA) and VerifyNow® system in determination of the prevalence of aspirin resistance (AR) and investigated the correlation between its presence and poor outcome (modifi ed Rankin scale >2) in 105patients with aspirin after acute ischemic stroke (AIS). Results: After 5 days of using aspirin, 15 patients (14.3%) were classifi ed as aspirin-resistance with the use of IPA, 24 patients (22.9%) by the LTA, and 14 patients (13.3%) by VerifyNow. Good agreement between the results of IPA and VerifyNow, was found (R=0.674, P <0.01). The concordance rate of AR detection was high between VerifyNow and IPA (k=0.72, P <0.01), albeit quite low between LTA and IPA. Regarding on its infl uence on clinical outcome after AIS, there wasn’t any signifi cant relationship between occurrence of poor outcome and the presence of AR in three platelet function assays. Conclusion: This study reveals that the incidence of AR in AIS might be highly test-specifi c. IPA seems to be similar to VerifyNow as a platelet function test.

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    참고문헌 (Reference)

    1 Mueller T, "Utility of the PFA-100 instrument and the novel multiplate analyzer for the assessment of aspirin and clopidogrel effects on platelet function in patients with cardiovascular disease" 15 : 652-659, 2009

    2 Ferguson JJ., "The role of oral antiplatelet agents in atherothrombotic disease" 6 : 149-157, 2006

    3 Can MM, "The risk of false results in the assessment of platelet function in the absence of antiplatelet medication: comparison of the PFA-100, multiplate electrical impedance aggregometry and verify now assays" 125 : 132-137, 2010

    4 International Stroke Trial Collaborative Group, "The International Stroke Trial (IST): A randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke" 349 : 1569-1581, 1997

    5 Pamukcu B, "Snezhitskiy V, Shantsila E. The CD40-CD40L system in cardiovascular disease" 43 : 331-340, 2011

    6 Liao JK, "Secondary prevention of stroke and transient ischemic attack: is more platelet inhibition the answer?" 115 : 1615-1621, 2007

    7 Harrison P, "Screening for aspirin responsiveness after transient ischemic attack and stroke: comparison of 2 point-of-care platelet function tests with optical aggregometry" 36 : 1001-1005, 2005

    8 Harrison P., "Progress in the assessment of platelet function" 111 : 733-744, 2000

    9 Kharbanda RK, "Prevention of inflammation-induced endothelial dysfunction: a novel vasculo-protective action of aspirin" 4 : 2600-2604, 2002

    10 Gurbel PA, "Platelet function monitoring in patients with coronary artery disease" 50 : 1822-1834, 2007

    1 Mueller T, "Utility of the PFA-100 instrument and the novel multiplate analyzer for the assessment of aspirin and clopidogrel effects on platelet function in patients with cardiovascular disease" 15 : 652-659, 2009

    2 Ferguson JJ., "The role of oral antiplatelet agents in atherothrombotic disease" 6 : 149-157, 2006

    3 Can MM, "The risk of false results in the assessment of platelet function in the absence of antiplatelet medication: comparison of the PFA-100, multiplate electrical impedance aggregometry and verify now assays" 125 : 132-137, 2010

    4 International Stroke Trial Collaborative Group, "The International Stroke Trial (IST): A randomised trial of aspirin, subcutaneous heparin, both, or neither among 19435 patients with acute ischaemic stroke" 349 : 1569-1581, 1997

    5 Pamukcu B, "Snezhitskiy V, Shantsila E. The CD40-CD40L system in cardiovascular disease" 43 : 331-340, 2011

    6 Liao JK, "Secondary prevention of stroke and transient ischemic attack: is more platelet inhibition the answer?" 115 : 1615-1621, 2007

    7 Harrison P, "Screening for aspirin responsiveness after transient ischemic attack and stroke: comparison of 2 point-of-care platelet function tests with optical aggregometry" 36 : 1001-1005, 2005

    8 Harrison P., "Progress in the assessment of platelet function" 111 : 733-744, 2000

    9 Kharbanda RK, "Prevention of inflammation-induced endothelial dysfunction: a novel vasculo-protective action of aspirin" 4 : 2600-2604, 2002

    10 Gurbel PA, "Platelet function monitoring in patients with coronary artery disease" 50 : 1822-1834, 2007

    11 Tóth O, "Multiple electrode aggregometry: a new device to measure platelet aggregation in whole blood" 96 : 781-788, 2006

    12 Harrison P, "Lack of reproducibility of assessment of aspirin responsiveness by optical aggregometry and two platelet function tests" 19 : 119-124, 2008

    13 Neumann F-J, "Induction of cytokine expression in leukocytes by binding of thrombin-stimulated platelets" 95 : 2387-2394, 1997

    14 Ogata J, "Heart and vessel pathology underlying brain infarction in 142 stroke patients" 63 : 770-781, 2008

    15 Jeon HW, "Factors related to progression of middle cerebral artery stenosis determined using transcranial Doppler ultrasonograhy" 25 : 265-269, 2008

    16 Adams HP, "Classification of subtype of acute ischemic stroke. Defi nitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment" 24 : 35-41, 1993

    17 CAST (Chinese Acute Stroke Trial) Collaborative Group, "CAST: Randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke" 349 : 1641-1649, 1997

    18 Jeon SB, "Biochemical aspirin resistance and recurrent lesions in patients with acute ischemic stroke" 64 : 51-57, 2010

    19 Ross R., "Atherosclerosis--an inflammatory disease" 14 (14): 115-126, 1999

    20 Paniccia R, "Assessment of platelet function on whole blood by multiple electrode aggregometry in high-risk patients with coronary artery disease receiving antiplatelet therapy" 131 : 834-842, 2009

    21 Krasopoulos G, "Aspirin“resistance” and risk of cardiovascular morbidity: systematicreview and meta-analysis" 336 : 195-198, 2008

    22 Englyst NA, "Aspirin resistance is more common in lacunar strokes than embolic strokes and is related to stroke severity" 28 : 1196-1203, 2008

    23 Boncoraglio GB, "Aspirin resistance determined with PFA-100 does not predict new thrombotic events in patients with stable ischemic cerebrovascular disease" 111 : 270-273, 2009

    24 Mason PJ, "Aspirin resistance and atherothrombotic diseases" 46 : 986-993, 2005

    25 Bugnicourt JM, "Aspirin non-responder status and early neurological deterioration: a prospective study" 113 : 196-201, 2011

    26 van Gijin J, "Aspirin and stroke prevention" 2 : 517-523, 2006

    27 McEver RP, "A receptor for neutrophils and monocytes on activated platelets and endothelium" 45 : 156-161, 1991

    28 Gum PA, "A prospective, blinded determination of the natural history of aspirin resistance among stable patients with cardiovascular disease" 41 : 961-965, 2003

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