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[Recurrence of Cerebral Infarction Associated Aspirin Resistance or Chinese Medical Constitutions: a Correlation
Insights
Recurrent cerebral infarction is linked to aspirin resistance (AR) and specific Chinese medical (CM) constitutions, particularly yin deficiency constitution. The GP IIb HPA-3 bb genotype may also increase the risk of AR and stroke recurrence.
Area of Science:
- Neurology
- Pharmacology
- Genetics
- Traditional Chinese Medicine
Background:
- Aspirin resistance (AR) is a growing concern in preventing recurrent cerebral infarction.
- Understanding the influence of traditional Chinese medical (CM) constitutions on AR and stroke recurrence is crucial for personalized treatment strategies.
Purpose of the Study:
- To investigate the correlation between aspirin resistance (AR), Chinese medical (CM) constitutions, and the recurrence of cerebral infarction.
- To identify potential risk factors, including genetic polymorphisms, associated with AR and recurrent stroke.
Main Methods:
- A cohort of 413 cerebral infarction patients receiving Aspirin Enteric-coated Tablets were followed for 12 months.
- Aspirin sensitivity (AS) was assessed, and CM constitutions were compared among patients with different AS levels.
- Logistic regression analysis was used to determine correlations between cerebral infarction recurrence, AR, GP IIb HPA-3 genotypes, and CM constitutions.
Main Results:
- Aspirin resistance (AR) was significantly higher in patients with recurrent cerebral infarction (71.3%) compared to those without recurrence (26.6%).
- Yin deficiency constitution (YDC) was most prevalent among AR patients, and also associated with higher recurrence rates in AR patients.
- The GP IIb HPA-3 bb genotype was found to be a significant risk factor for AR and recurrent cerebral infarction.
Conclusions:
- Recurrent cerebral infarction is strongly associated with aspirin resistance (AR) and specific CM constitutional types.
- Patients with AR and a yin deficiency constitution (YDC) exhibit a higher risk of stroke recurrence.
- The GP IIb HPA-3 bb genotype may serve as a predictive marker for AR and recurrent cerebral infarction, highlighting the interplay between genetics, AR, and CM constitutions.
Objective:
To explore the correlation between the recurrence of cerebral infarction and aspirin resistance (AR)/Chinese medical (CM) constitutions.
Methods:
Totally 413 cerebral infarction patients took Aspirin Enteric-coated Tablet (100 mg per day) while receiving routine therapy, 5 days at least in a week. They were followed-up for 12 months. Aspirin sensitivity (AS) was determined using turbidimetry. CM constitutions among patients with different AS were compared. Ratios of AR patients and AS patients of different CM constitutions in cerebral infarction recurrent patients were compared. Platelet membrane glycoproteins (GP) II b HPA-3 gene polymorphism was detected by polymerase chain reaction (PCR) method. Correlation between recurrence of cerebral infarction and AR, bb genotypes, CM constitutions times AS were analyzed by Logistic regression.
Results:
Totally 11 patients dropped out, 101 (25.12%)with recurrent cerebral infarction and 301 (74.88%) without recurrent cerebral infarction. There were 152 (37.81%) AR patients and 250 (62.19%) AS patients. AR accounted for 26.6% (80/ 301) and AS accounted for 73.4% (221/301) in non-recurrent cerebral infarction patients. AR accounted for 71.3% (72/101) and AS accounted for 28.7% (29/101) in recurrent cerebral infarction patients. There was statistical difference in AR and AS ratios (χ2 = 64.287, P = 0.000). The proportion of yin deficiency constitution (YDC) was the largest [28.3% (43/152)] in AR patients. The proportion of blood stasis constitution (BSC) was the largest [23.6% (59/250)] in AS patients. There was statistical difference in CM constitutions between AR patients and AS patients (χ2 = 21.574, P < 0.01). The former 4 recurrent rates occurred in AR patients of YDC, BSC, damp-phlegm constitution (DPC), qi deficiency constitution (QDC). YDC occupied the first place [22.4% (34/152)]. The former 4 recurrent rates occurred in AS patients of BSC, QDC, DPC, damp-heat constitution (DHC). BSC occupied the first place [3.2% (2/250)]. Compared with non-recurrent cerebral infarction patients and AS patients, bb gene occurred most often, but aa gene and ab gene occurred obviously lesser in non-recurrent cerebral infarction patients and AR patients (χ2 = 20.171, χ2 = 55.139, P < 0.01). AR and bb gene were positively correlated with recurrent cerebral infarction (OR = 18.423, P = 0.000; OR = 1.304, P = 0.028). Body constitutions interacted with AS (OR = 0.707, P = 0.000).
Conclusions:
Recurrent cerebral infarction was closely related to AR and constitutional types. The recurrence rate was higher in AR patients of YDC. GP I b HPA-3 bb genotype might be a risk factor for AR and recurrent cerebral infarction.
