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Platelet Function Testing in Patients with Acute Ischemic Stroke: An Observational Study.

Francesca Rosafio1, Nicoletta Lelli2, Stefano Mimmi3

  • 1Stroke Unit, Neurology Clinic, Department of Neuroscience, Nuovo Ospedale Civile S. Agostino-Estense, University Hospital of Modena, Modena, Italy.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|June 4, 2017
PubMed
Summary
This summary is machine-generated.

Platelet function testing in stroke patients reveals significant aspirin (ASA) resistance, especially with clopidogrel therapy. Monitoring platelet reactivity may improve antiplatelet treatment strategies for stroke prevention.

Keywords:
Ischemic strokeaggregometryplatelet inhibitorsecondary prevention

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Area of Science:

  • Cardiovascular Medicine
  • Clinical Pharmacology
  • Neuroscience

Background:

  • Platelet reactivity measurement is underutilized in clinical practice for stroke patients on antiplatelet therapy.
  • Assessing therapy responsiveness in stroke patients, comparing those on prevention versus naive to antiplatelet agents, is crucial.
  • Investigating differences in responsiveness across etiological subtypes and genetic correlations is needed.

Purpose of the Study:

  • To assess the prevalence of antiplatelet therapy responsiveness in stroke patients.
  • To compare responsiveness between patients naive to antiplatelet medications and those on prevention therapy.
  • To explore differences in responsiveness among etiological subtypes and correlations with CYP2C19 polymorphisms.

Main Methods:

  • Included 624 stroke patients on antiplatelet therapy, categorized as 'naive' or 'non-naive'.
  • Measured platelet function using multiple electrode aggregometry.
  • Determined CYP2C19 polymorphisms via genotyping assays.

Main Results:

  • Aspirin (ASA) responsiveness was higher in naive patients (94.9%) versus non-naive (82.6%).
  • ASA showed better responsiveness than clopidogrel or combination therapy across all patient groups.
  • Clopidogrel was identified as a risk factor for unresponsiveness (OR 3.652).
  • No significant differences were found between etiological subgroups or correlations with CYP2C19 polymorphisms.

Conclusions:

  • Platelet function testing may be valuable for monitoring antiplatelet therapy effectiveness in stroke patients.
  • A significant proportion of stroke patients exhibit resistance to ASA, with higher rates of unresponsiveness observed with clopidogrel.
  • Further longitudinal studies are required to determine if aggregometry can provide prognostic information and guide prevention strategies.