Assessment of platelet function in patients with stroke using multiple electrode platelet aggregometry: a prospective...

Area of Science:

• Cardiology
• Neurology
• Pharmacology

Background:

• High on-treatment platelet reactivity (HPR) is associated with increased vascular events in stroke patients.
• Understanding HPR prevalence and its relation to antiplatelet (AP) drug efficacy is crucial for stroke management.

Purpose of the Study:

• To compare multiple electrode platelet aggregometry (MEA) in healthy individuals and ischemic stroke patients.
• To assess MEA differences between AP-naive patients and those on regular low-dose AP.
• To determine the prevalence of HPR at baseline and after aspirin loading doses.

Main Methods:

• Age and sex-matched study design comparing 70 ischemic stroke patients with 72 healthy controls.
• Multiple electrode platelet aggregometry (MEA) using arachidonic acid (ASPI), adenosine diphosphate (ADP), and collagen (COL) agonists.
• Blood samples collected at baseline, 24 hours, and 3-5 days post-treatment initiation.

Main Results:

• AP-naive patients exhibited significantly higher MEA results for all tested agonists compared to healthy subjects.
• A significant proportion of patients on long-term AP (33%) demonstrated aspirin resistance.
• Aspirin resistance decreased to 11.1% at 3-5 days following aspirin loading doses.

Conclusions:

• A considerable number of patients on low-dose aspirin meet criteria for aspirin resistance, though this is reduced after loading doses.
• Further research is necessary to elucidate HPR causes and the benefits of personalized AP treatment guided by platelet function testing.