Kyung Chul Noh, Dae-il Chang, Sun Uk Kwon and Bum Joon Kim
Kyung Hee University College of Medicine, Republic of Korea
Asan Medical Center, Republic of Korea
Posters & Accepted Abstracts: J Neurol Neurophysiol
Treatment failure of stroke is commonly attributed to multiple causes, including vascular factors causing increased
platelet activation or failure to uncover the true cause or mechanism of stroke. Clinicians are faced with options
of switching to a new antiplatelet medication or using a combination of antiplatelet medications in the acute setting
and for long-term secondary stroke prevention, balancing future protective benefit and risks. We have consecutively
enrolled patients with ischemic stroke classified as LAA and under the use of aspirin. Ischemic stroke was classified
according to the location of atherosclerosis, ischemic lesion pattern and mechanism of stroke. Aspirin resistance unit
(ARU) was measured at the day of admission ARU>550 was regarded as resistant to aspirin. ARU and proportion of
patients with aspirin resistance was compared among different groups. ARU was higher in those with extracranial
than intracranial atherosclerosis (492.9 vs., 461.8; respectively, p=0.007). Aspirin resistance was more frequently
observed from extracranial atherosclerosis (28.8% vs., 10.3%; P=0.001). By mechanism ARU was low in those with
local branch occlusion than other mechanisms (p=0.037). Aspirin resistance was less frequent in those with local
branch occlusion (20.2% vs., 3.4%; p=0.029) Similarly, ARU was most low in those with subcortical infarction
pattern (p=-0.001). ARU in Ischemic stroke due to LAA differs according to the mechanism of stroke. Ischemic
stroke occurring under aspirin due to extracranial atherosclerosis and artery-to-artery embolism is associated with
aspirin resistance, whereas the role of platelet inhibition is limited in ischemic stroke due to local branch occlusion
in intracranial atherosclerosis.
Recent publications:
1. Kernan W N, Ovbiagele B and Black H R, et al. (2014) Guidelines for the prevention of stroke in patients
with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart
Association/American Stroke Association. Stroke 45(7):2160-236.
2. Badimon L and Vilahur G (2014) Thrombosis formation on atherosclerotic lesions and plaque rupture. J Intern.
Med. 276(6):618-32.
3. Furie K L, Kasner S E and Adams R J, et al. (2011) Guidelines for the prevention of stroke in patients with stroke
or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/
American Stroke Association. Stroke 42:227-76.
4. Yip S and Benavente O (2011) Antiplatelet agents for stroke prevention. Neurotherapeutics 8(3):475-87
Kyung Chul Noh has expertise in stroke evaluation and passion in improving the health in Korea. He is in the first year of stroke fellowship in Asan Medical Center, Seoul, South Korea and majoring in stroke. He is interested in personalized treatment in Neurology field, adjusting antiplatelet or anticoagulation therapy in each stroke patient.
E-mail: kyungchulnoh85@gmail.com
