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J Korean Neurol Assoc. 2011;29(4):303-308.
- Biochemical Aspirin Resistance Affect on Stroke Severity in Acute
Stroke Patients Who Had Taken Aspirin
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Ji Hoon Kim
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Department of Neurology
a
, Keimyung University School of Medicine, Daegu, Korea
Department of Neurology
b
, Korea University College of Medicine, Seoul, Korea
- 아스피린을 복용하던 급성 뇌경색 환자에서 생화학적
아스피린저항성이 뇌경색의 중증도에 미치는 영향
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김지훈, 김연수
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계명대학교 의과대학 신경과학교실
a
, 고려대학교 의과대학 신경과학교실
b
- Abstract
- Background
There are conflicting data in the literature regarding aspirin resistance. This study evaluated the effect of
biochemical aspirin resistance on initial stroke severity in acute stroke patients who had taken aspirin.
Methods
We reviewed acute ischemic stroke patients who were already on aspirin. Biochemical aspirin resistance was
defined as an aspirin reaction unit score of ≥550, as evidenced by the VerifyNow-Aspirin assay, which was performed
after 4?days of continuous aspirin medication. Initial stroke severity was evaluated using National Institutes of Health
Stroke Scale (NIHSS) scores at day 4, which were dichotomized into mild (0-7) and severe (≥8). Modified Rankin Scale
scores were determined at 3?months. The Alberta Stroke Program Early CT Scores (ASPECTS) were assessed on initial
diffusion-weighted imaging (DWI). We examined the relationships between biochemical aspirin resistance and initial
stroke severity.
Results
Nine of 106 patients (8.5%) had biochemical aspirin resistance. The initial stroke severity was significantly
associated with DWI-ASPECTS (p<0.001), initial C-reactive protein level (p=0.005), biochemical aspirin resistance
(p=0.009), and stenosis or occlusion of the relevant artery (p=0.029). Multivariate analysis showed that biochemical
aspirin resistance [odds ratio (OR), 15.24; 95% confidence interval (CI), 2.49-93.31; p=0.003] and initial C-reactive protein
level (per 1?mg/dL; OR, 2.43; 95% CI, 1.47-4.00; p=0.001) were independently associated with initial stroke severity
(NIHSS score ≥8). However, biochemical aspirin resistance was not associated with clinical outcome at 3?months
(p=0.366).
Conclusions
Biochemical aspirin resistance was independently associated with initial stroke severity. This suggests that
detection of biochemical aspirin resistance in acute ischemic stroke is useful when choosing the optimal treatment. Key Words: Aspirin, Resistance, Stroke, Prevention
Keywords :
- 초록
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