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Assessment of the relationship between platelet reactivity, vascular risk factors and gender in cerebral ischaemia patients
Affiliations- Klinika Neurologii, Collegium Medicum w Bydgoszczy, Uniwersytet Mikołaja Kopernika w Toruniu, Skłodowskiej 9, 85-094 Bydgoszcz, Poland
- Laboratory for Experimental Biotechnology, Faculty of Medicine, Nicolaus Copernicus University in Toruń, Collegum Medicum in Bydgoszcz, 85-094 Bydgoszcz, Poland
- Department of Neurological and Neurosurgical Nursing, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Collegum Medicum in Bydgoszcz, 85-821 Bydgoszcz, Poland
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Abstract
Aim. Excessive activation and platelet aggregation play important roles in the aetiopathogenesis of cerebral ischaemia. The aim of this study was to assess the relationship between platelet reactivity, gender and vascular risk factors in cerebral ischaemia patients.
Clinical rationale for the study. The research is useful because we found high risk groups of inefficient aspirin treatment in cerebral ischaemia patients.
Material and methods. The study involved 101 patients, including 69 patients with ischaemic stroke and 32 patients with transient ischaemic attack. The assessment of platelet reactivity was made within 24 hours of the disease onset using two aggregometric methods: impedance and optical.
Results. Resistance to acetylsalicylic acid among people with cerebral ischaemia was estimated at 30.69% using impedance aggregometry and 9.2% using optical aggregometry. There were no differences in platelet reactivity or ASA resistance between the groups of patients with stroke and TIA in either method. In the whole group of patients (p = 0.04), and in the group of patients with stroke (p = 0.0143), higher reactivity of platelets was observed by impedance aggregometry in men than in women. In the whole group of patients (p = 0.0229), and in the subgroup with stroke (p = 0.0123), it was shown that aspirin resistance is significantly more common in the subgroup of men than in women. In patients suffering from nicotine addiction, significantly higher platelet reactivity was found in the whole group of patients (p = 0.004), as well as in the subgroup of patients with stroke (p = 0.0135).
Conclusions. There are no differences between platelet reactivity and the incidence of aspirin resistance in patients with stroke and TIA. Male gender and smoking are associated with greater reactivity of platelets and more frequent occurrence of acetylsalicylic acid resistance in patients with cerebral ischaemia.
Clinical implications. Dual antiplatelet therapy or clopidogrel treatment should be considered in smoking males with cerebral ischaemia due to the high risk of aspirin inefficiency.
Abstract
Aim. Excessive activation and platelet aggregation play important roles in the aetiopathogenesis of cerebral ischaemia. The aim of this study was to assess the relationship between platelet reactivity, gender and vascular risk factors in cerebral ischaemia patients.
Clinical rationale for the study. The research is useful because we found high risk groups of inefficient aspirin treatment in cerebral ischaemia patients.
Material and methods. The study involved 101 patients, including 69 patients with ischaemic stroke and 32 patients with transient ischaemic attack. The assessment of platelet reactivity was made within 24 hours of the disease onset using two aggregometric methods: impedance and optical.
Results. Resistance to acetylsalicylic acid among people with cerebral ischaemia was estimated at 30.69% using impedance aggregometry and 9.2% using optical aggregometry. There were no differences in platelet reactivity or ASA resistance between the groups of patients with stroke and TIA in either method. In the whole group of patients (p = 0.04), and in the group of patients with stroke (p = 0.0143), higher reactivity of platelets was observed by impedance aggregometry in men than in women. In the whole group of patients (p = 0.0229), and in the subgroup with stroke (p = 0.0123), it was shown that aspirin resistance is significantly more common in the subgroup of men than in women. In patients suffering from nicotine addiction, significantly higher platelet reactivity was found in the whole group of patients (p = 0.004), as well as in the subgroup of patients with stroke (p = 0.0135).
Conclusions. There are no differences between platelet reactivity and the incidence of aspirin resistance in patients with stroke and TIA. Male gender and smoking are associated with greater reactivity of platelets and more frequent occurrence of acetylsalicylic acid resistance in patients with cerebral ischaemia.
Clinical implications. Dual antiplatelet therapy or clopidogrel treatment should be considered in smoking males with cerebral ischaemia due to the high risk of aspirin inefficiency.
Keywords
platelet reactivity, stroke, aspirin resistance, gender, risk factors
About this articleTitle
Assessment of the relationship between platelet reactivity, vascular risk factors and gender in cerebral ischaemia patients
Journal
Neurologia i Neurochirurgia Polska
Issue
Article type
Research Paper
Pages
258-264
Published online
2019-07-25
Page views
2142
Article views/downloads
280
DOI
Pubmed
Bibliographic record
Neurol Neurochir Pol 2019;53(4):258-264.
Keywords
platelet reactivity
stroke
aspirin resistance
gender
risk factors
Authors
Adam Wiśniewski
Joanna Sikora
Karolina Filipska
Grzegorz Kozera
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