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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
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Aspirin resistant patients with recent ischemic stroke
L Castilla-Guerra1, M S Navas-Alcántara1, M C Fernández-Moreno2
1Servicio de Medicina Interna, Hospital de la Merced, Osuna, Sevilla, España.
Revista Clinica Espanola
|November 12, 2013
Summary
Some patients experience recurrent ischemic strokes despite aspirin treatment, termed aspirin resistance. This resistance significantly elevates stroke risk and severity, necessitating careful evaluation for true resistance versus pseudo-resistance.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Pharmacology
Background:
- Aspirin is a standard antiplatelet therapy for ischemic stroke prevention.
- A subset of patients (15-25%) on aspirin therapy experience recurrent ischemic strokes.
Observation:
- These patients are described as aspirin-unresponsive or aspirin-resistant.
- Aspirin resistance is associated with a fourfold increased risk of stroke.
- Strokes in these patients tend to be more severe, with larger infarcts and higher recurrence rates.
Findings:
- Currently, no definitive laboratory test exists to identify aspirin resistance.
- The study highlights the importance of ruling out pseudo-resistance, such as non-compliance or drug interactions, before considering true aspirin resistance.
Implications:
- Understanding aspirin resistance is crucial for optimizing secondary stroke prevention strategies.
- Further research is needed to develop reliable diagnostic tools for aspirin resistance.
- Clinical management should prioritize adherence and review of concomitant medications in patients with recurrent ischemic events.
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