scholarly journals Antiplatelet Effect of Aspirin in Ischemic Stroke: A Hospital-based Study

2021 ◽  
pp. 237-244
Author(s):  
Masaraf Hussain ◽  
Yookarin Khonglah ◽  
S. R. Sharma ◽  
Baia Synmon ◽  
Yasmeen Hynniewta
Keyword(s):  
Ischemic Stroke ◽  
Light Transmission ◽  
Study Groups ◽  
Aspirin Resistance ◽  
Functional Improvement ◽  
Genetic Profile ◽  
Stroke Patients ◽  
Antiplatelet Effect ◽  
Platelet Aggregometry ◽  
To Come

Introduction: Aspirin is widely used for the treatment of stroke. Therefore aspirin resistance can lead to a significant increase in the burden of stroke. Platelet aggregation studies can evaluate platelet function, and this may help to detect anti-platelet resistance. Methods: This is a hospital-based study of the antiplatelet effect of aspirin in ischemic stroke, during a duration of one year. All first-time ischemic stroke patients >18 years of age were included. Platelet aggregometry test was done by LTA (Light transmission optical aggregometer), after starting the patients on oral aspirin. Results: A total of 113 ischemic stroke patients were included for the antiplatelet effect of the aspirin study.  Aspirin resistance was found in 18.58% of patients. Patients with aspirin resistance had higher mortality, and less improvement on follow-up, as compared to aspirin-sensitive patients. They had more incidence of smoking, alcohol abuse, diabetes mellitus, and dyslipidemia, as compared to the aspirin-sensitive group. The results reveal that there is a non-statistically significant trend in both mortality and prognosis between the two study groups compared: aspirin-resistant versus aspirin-sensitive patients. Conclusion: Aspirin resistance can lead to loss of functional improvement and more mortality than aspirin-sensitive patients. However, further study for drug interactions, adequate risk factor control, the genetic profile of the population is needed, to come to a definite conclusion.

POSITIVE: Perfusion imaging selection of ischemic stroke patients for endovascular therapy

2021 ◽  
pp. neurintsurg-2021-017315
Author(s):  
J Mocco ◽  
Adnan H Siddiqui ◽  
David Fiorella ◽  
Michael J Alexander ◽  
Adam S Arthur ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Endovascular Therapy ◽  
Perfusion Imaging ◽  
Medical Management ◽  
Primary Outcome ◽  
Functional Improvement ◽  
Positive Trial ◽  
Stroke Patients ◽  
Number Of Patients ◽  
Selection Of

BackgroundThe PerfusiOn imaging Selection of Ischemic sTroke patIents for endoVascular thErapy (POSITIVE) trial was designed to evaluate functional outcome in patients with emergent large vessel occlusion (ELVO) presenting within 0–12 hours with pre-specified bifurcated arms of early and late window presentation, who were selected for endovascular thrombectomy with non-vendor specific commercially available perfusion imaging software. Recent trials demonstrating the benefit of thrombectomy up to 16–24 hours following ELVO removed equipoise to randomize late window ELVO patients and therefore the trial was halted.MethodsUp to 200 patients were to be enrolled in this FDA-cleared, prospective, randomized, multicenter international trial to compare thrombectomy and best medical management in patients with ELVO ineligible for or refractory to treatment with IV tissue plasminogen activator (IV-tPA) selected with perfusion imaging and presenting within 0–12 hours of last seen normal. The primary outcome was 90-day clinical outcome as measured by the raw modified Rankin Scale (mRS) with scores 5 and 6 collapsed (mRS shift analysis).ResultsThe POSITIVE trial suspended enrollment with the release of results from the DAWN trial and was stopped after the release of the DEFUSE 3 trial results. Thirty-three patients were enrolled (21 for medical management and 12 for thrombectomy). Twelve of the 33 patients were enrolled in the 6–12 hour cohort. Despite the early cessation, the primary outcome demonstrated statistically significant superior clinical outcomes for patients treated with thrombectomy (P=0.0060). The overall proportion of patients achieving an mRS score of 0–2 was 75% in the thrombectomy cohort and 43% in the medical management cohort (OR 4.00, 95% CI 0.84 to 19.2).ConclusionPOSITIVE supports the already established practice of delayed thrombectomy for appropriately selected patients presenting within 0–12 hours selected by perfusion imaging from any vendor. The results of the POSITIVE trial are consistent with other thrombectomy trials. The statistically significant effect on functional improvement, despite the small number of patients, reinforces the robust benefits of thrombectomy.Clinical trial registrationNCT01852201

Interaction Between vWF Levels and Aspirin Resistance in Ischemic Stroke Patients

2013 ◽  
Vol 4 (5) ◽  
pp. 484-487 ◽  
Author(s):  
Yıldız Arslan ◽  
Tahir Kurtuluş Yoldaş ◽  
Yaşar Zorlu
Keyword(s):  
Ischemic Stroke ◽  
Aspirin Resistance ◽  
Stroke Patients

scholarly journals Biochemical aspirin resistance is associated with increased stroke severity and infarct volumes in ischemic stroke patients

Oncotarget ◽  
2017 ◽  
Vol 8 (44) ◽  
pp. 77086-77095 ◽  
Author(s):  
Xuan Cheng ◽  
Nan-Chang Xie ◽  
Hong-Liang Xu ◽  
Chen Chen ◽  
Ya-Jun Lian
Keyword(s):  
Ischemic Stroke ◽  
Aspirin Resistance ◽  
Stroke Severity ◽  
Stroke Patients

scholarly journals Frequency of Aspirin Resistance in Ischemic Stroke Patients and Healthy Controls from Colombia

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Alejandro Roman-Gonzalez ◽  
Carlos Andrés Naranjo ◽  
Walter D. Cardona-Maya ◽  
Dionis Vallejo ◽  
Francisco Garcia ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Platelet Aggregation ◽  
Univariate Analysis ◽  
Aspirin Resistance ◽  
Aspirin Therapy ◽  
Stroke Recurrence ◽  
Healthy Controls ◽  
Test Results ◽  
Stroke Patients ◽  
Ischemic Cerebrovascular Disease

Objective. To evaluate the aspirin resistance prevalence in patients with previous ischemic cerebrovascular disease undergoing aspirin therapy for secondary prevention. Materials and Methods. Three hundred fifty patients presenting ischemic strokes and 100 healthy controls under aspirin treatment were evaluated using the optic platelet aggregation test. Results. Aspirin resistance was found in 7.4% of the patients with ischemic stroke and 4% of controls. Aspirin resistance was associated with stroke recurrence in univariate analysis ( p = 0.004 ). Aspirin resistance was not associated with smoking, diabetes, or hypercholesterolemia. Conclusion. Aspirin resistance is present in Colombian patients with ischemic stroke as well as in healthy controls.

Pharmacogenetics and the Antiplatelet Effect of Clopidogrel in North Indian Ischemic Stroke Patients

2018 ◽  
Vol 32 ◽  
pp. 133
Author(s):  
Dheeraj Khurana ◽  
Jitender Gairolla ◽  
Rupinder Kler ◽  
Madhu Khullar
Keyword(s):  
Ischemic Stroke ◽  
Stroke Patients ◽  
Antiplatelet Effect

Abstract WMP5: Clinical and Cost Effectiveness of Rapid Recanalization within 6 Hours Performed by Intraarterial Thrombectomy for Acute Ischemic Stroke Patients

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Hye Seon Jeong ◽  
Hee Seon Yu ◽  
Na Young Yoon ◽  
Hae Mi Lee ◽  
Jong Wook Shin ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cost Effectiveness ◽  
Acute Ischemic Stroke ◽  
Cost Effective ◽  
Medical Costs ◽  
Functional Independence ◽  
Quality Adjusted Life Year ◽  
Cost Utility ◽  
Functional Improvement ◽  
Stroke Patients

Introduction: Rapid recanalization using intraarterial thrombectomy (IAT) is recommended to achieve rapid functional improvement and to shorten admission and rehabilitation period for acute ischemic stroke patients. We evaluated clinical and cost effectiveness of rapid recanalization within 6 hours by comparison with recanalization over 6 hours and no-recanalization of the occluded vessels in acute ischemic stroke patients. Methods: We analyzed clinical outcomes and medical costs of 230 acute ischemic stroke patients, who received IAT from October 2010 to May 2015. Patients were classified into rapid- (<6 hrs, n=143) and late- (> 6hrs, n=31) recanalization (≥2b or 3 of Thrombolysis in Cerebral Infarction grade [TICI]), and no-recanalization (TICI ≤2a, n=56) groups by the recanalization status after IAT. Differences of functional independence defined as 0-2 modified Rankin Score and medical costs checked at discharge and 1 year after IAT were compared between three groups. We also evaluated quality-adjusted life year (QALY) using EQ-5D 3 level version at 1 year after IAT and compared mortality and cost-effectiveness differences between the groups using QALY. Results: Functional independence was significantly higher in rapid-recanalization group than others at discharge (rapid-, 57%, vs. late-, 23% vs. no-recanalization, 0%, p <0.001) and after 1 year (70% vs. 40% vs. 6%, p <0.001). QALY (0.71±0.41 vs. 0.52±0.45 vs. 0.15±0.34, p <0.001) checked at 1 year was also higher in rapid-recanalization group than the others. Instead, one year mortality was lower in rapid-group than the others (10% vs. 17% vs. 43%, p <0.001). Medical cost of rapid-recanalization group was lower than other two groups at discharge ($9515 vs. $12711 vs. $12460, p <0.001) and after 1 year ($16753 vs. $21957 vs. $30718, p <0.001). On QALY adjusted cost-utility analysis, rapid-recanalization after IAT was more cost effective than late- ($27389/QALY) and no-recanalization ($51059/QALY) for acute ischemic stroke patients. Conclusions: The present data showed the importance of rapid recanalization within 6 hrs of acute ischemic stroke patients using IAT to reduce economic burden by the enhancement of functional outcomes during admission and after discharge.

Sign in / Sign up

Export Citation Format

Share Document