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. 2017 Aug 18;8(44):77086-77095.
doi: 10.18632/oncotarget.20356. eCollection 2017 Sep 29.

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

Xuan Cheng  1 , Nan-Chang Xie  1 , Hong-Liang Xu  1 , Chen Chen  1 , Ya-Jun Lian  1
Affiliations

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

Xuan Cheng et al. Oncotarget. .

Abstract

To explore the correlation of aspirin resistance (AR) with clinical stroke severity and infarct volume using diffusion-weighted imaging (DWI) in 224 Chinese ischemic stroke patients who were taking aspirin before stroke onset. In those patients, the median age was 64 years (IQR, 56-75 years), and males accounting for 54.9%(123)of the total subjects. Fifty of 224 enrolled patients (22.3%; 95% confidence interval (CI), 16.9% to 27.7%) showed AR. In the median regression model, significant increase was estimated in NIHSS score of 0.04 point for every 1-point increase in aspirin reaction units (ARU) (95% CI, 0.02 to 0.06; P<0.001). Diffusion-weighted MRI (DWI)-measured infarct volume were significantly higher in patients with AR as compared with those with AS [13.21 (interquartile ranges [IQR], 8.51-23.88) vs.4.26 (IQR, 1.74-11.62); P<0.001). Furthermore, a statistically significant increase was also measured in NIHSS score of 0.05 point for every 1-point increase in ARU in the median regression model (95% CI, 0.03 to 0.08; P<0.001). The median DWI infarct volume was significantly larger in the highest ARU quartile when compared to that in the low 3 quartiles (P<0.001). In conclusion, stroke patients with AR indicated higher risk of severe strokes and large infarcts compared to patients in the aspirin-sensitive group.

Keywords: aspirin resistance; diffusion-weighted imaging; infarct volume; stroke severity.

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Conflict of interest statement

CONFLICTS OF INTEREST On behalf of all authors, the corresponding author states that there is no conflicts of interest.

Figures

Figure 1
Figure 1. The linear association between ARU and NIHSS score
The slash lines represent the trend line and 95%CI. ARU=aspirin reaction units; NIHSS=National Institutes of Health Stroke Scale.
Figure 2
Figure 2. Variation of DWI Infarct volume between AS and AR patients
All data are medians and in-terquartile ranges (IQR). P values refer to Mann-Whitney U tests for differences between groups. AR=aspirin-resistant; AS=aspirin-sensitive; DWI=Diffusion-Weighted Magnetic Resonance Imaging; ARU=aspirin reaction units
See this image and copyright information in PMC

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