Abstract W P242: Clinical Implications of Changes of Aspirin Reaction Unit in Acute Ischemic Stroke
Background: Some studies have shown that biological aspirin resistance (BAR) could be associated with an increased risk of early neurological deterioration (END). Considering the risk of END and recurrent stroke is greatest during the acute phase, it would be important to investigate the influences of acute BAR on early outcomes in acute ischemic stroke. However, it is still controversial if assays of aspirin resistance might accurate and consistent. Therefore, we sought to find whether the changes of aspirin responsiveness might be associated with END in patients with acute ischemic stroke.
Methods: This study was a part 1 study of ongoing, single center, prospective observational study. Patients of part 1 study were consecutively recruited from our tertiary stroke center. These patients were those who (1) presented and were evaluated within the first 24 hours of symptom onset; (2) were no potential risks of cardioembolism; and (3) provided written informed consent. Aspirin reaction unit (ARU) was assessed using the VerifyNow. Acute ARU (aARU) was measured at 3 hours after aspirin loading in emergent department. Follow-up ARU (fuARU) was performed after 5 consecutive days of aspirin medication. An ARU value ≥ 550 was defined as BAR. Differences between fuARU and aARU were defined as “changes of ARU”. To evaluate the association between changes of ARU and END, ‘changes of ARU’ were classified according to 4 equal sized groups. END was defined as an increase in NIHSS scores by 1 or more points between hospital days 0 and 5.
Results: Three-hundreds forty nine patients were performed both aARU and fuARU. END occurred in 72 (20.6%) patients. Patients with END had higher values of changes of ARU than those without (-7.1 vs -29.6, p=0.040, respectively). Furthermore, END more frequently occurred in patients in forth quartiles than those in other quatiles of changes of ARU (4th quartiles: OR, 3.188; 95% CI, 1.431-7.104; p=0.005).
Conclusions: Our results showed that increase of fuARU was independently associated with END. The results of our study suggested that in acute stage of ischemic stroke, it may be helpful for serial assay of aspirin responsiveness to evaluate the association between early outcomes and aspirin resistance.
Author Disclosures: J. Kim: None. K. Choi: None. M. Park: None. K. Cho: None.
- © 2014 by American Heart Association, Inc.