Saturday, 15 December 2012

Stroke likely to recur in Chinese patients as 1 in 4 have aspirin resistance

One in four patients is aspirin resistant and this increases their risk of recurrent stroke
by Michael Woodhead
Aspirin resistance is present in one in four Chinese patients who have a stroke and may explain why there is a high rate of recurrent events, researches from Zhejiang say.
In a study of 634 Chinese stroke patients, Dr Yi Xingyang and other researchers from the Department of Neurology at the 3rd Affiliated Hospital of Wenzhou Medical College, found that 20% had aspirin resistance and a further 5% had partial aspirin resistance.
Patients who had diabetes or high levels of LDL  cholesterol were especially likely to have aspirin resistance, perhaps due to platelet activation and thrombosis, they found.
Rates of recurrent cardiovascular events such as stroke and heart attack were more than 30% in patients with aspirin resistance compared to only12% in the aspirin sensitive patients.
The researchers say resistance to the antiplatelet effects of aspirin is one explanation as to why aspirin may not be absolutely effective in preventing recurrent vascular events, and it is not uncommon for patients to experience a recurrent atherothrombotic vascular event in the subsequent years after their first stroke, despite taking aspirin.The finding that rates of recurrent stroke, heart attack and death and all vascular events were higher in patients with aspirin resistance shows that aspirin resistance seems to be a new predictor of vascular events, they say.
"To reduce the risk of thrombotic complications in patients detected to be aspirin resistant, increasing the dose of aspirin might be beneficial," they suggest.
"In conclusion, aspirin resistance is common in Chinese patients who receive antiplatelet medications. Diabetes and high LDL levels may increase the occurrence of AR due to platelet activation and thrombosis. Patients with AR may have a greater risk of suffering clinically important vascular events. To provide stroke prevention in patients with AR, other medications (e.g., statins, ACE inhibitors) should be considered to prevent the sequelae of vascular disease."
Source: International Journal of Stroke

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