ASPIRIN RESISTANCE IN NEUROVASCULAR DISEASES

Vališ, Martin; Krajíčková, Dagmar; Malý, Jaroslav; Malý, Radovan; Fátorová, Ilona; Vyšata, Oldřich; Herzig, Roman

doi:10.14712/18059694.2015.81

Acta Medica > Archive > 2014, Vol. 57 > Issue 4 > ASPIRIN RESISTANCE IN NEUROVASCULAR…

Acta Med. 2014, 57: 157-161

https://doi.org/10.14712/18059694.2015.81

ASPIRIN RESISTANCE IN NEUROVASCULAR DISEASES

Martin Vališ^a, Dagmar Krajíčková^a, Jaroslav Malý^b, Radovan Malý^b, Ilona Fátorová^b, Oldřich Vyšata^a,c, Roman Herzig^a

^aUniversity Hospital Hradec Králové and Charles University in Prague, Faculty of Medicine in Hradec Králové, Comprehensive Department of Neurology, Stroke Center, Czech Republic
^bUniversity Hospital Hradec Králové and Charles University in Prague, Faculty of Medicine in Hradec Králové, Department of Internal Medicine, Czech Republic
^cDepartment of Computing and Control Engineering, Institute of Chemical Technology, Prague, Czech Republic

Received January 17, 2014
Accepted January 28, 2015

Introduction: The issue of resistance to antiplatelet therapy has raised many questions in the area of neurovascular diseases. The first objective of this work was to determine the prevalence of aspirin resistance in neurovascular patients with clinical non-responsiveness to aspirin treatment and a high-risk of atherothrombotic complications using two interpretable and independent methods (aggregation and PFA 100). The second objective was to find the correlation between both assays and to evaluate the results in groups at risk for various cerebrovascular diseases. Material and methods: Laboratory tests of aspirin resistance were performed in 79 patients with clinical non-responsiveness to aspirin treatment suffering from neurovascular diseases. Patients were divided into the two groups: expected low risk for aspirin resistance due to the first manifestation of a neurovascular disease (n = 34) and expected high risk due to the second clinical manifestation of a neurovascular disease (n = 45). Results: The prevalence of aspirin resistance in both groups combined as determined by the PFA-100 and CPG techniques were 50.6% and 17.7%, respectively. No correlation was found between the two techniques. Conclusions: No significant prevalence of aspirin resistance was demonstrated by either method despite the heterogeneous pathophysiological mechanisms. However, we are presently unable to provide an accurate opinion on the value of laboratory test result or routine monitoring in clinical neurology.