It doesn't say how you tell you need to have this HRPR test that shows aspirin resistance so this is really completely worthless. Shows possible correlation not cause and effect. What should be done if you have this?
http://www.news-medical.net/news/20160412/Aspirin-resistance-signals-increased-stroke-severity.aspx
Stroke severity and infarct volume are significantly increased among
patients who become resistant to aspirin, show study findings published
in Neurology.
"Therefore laboratory tests for aspirin resistance should be
considered before modifying an antiplatelet regimen in patients who
experience new or recurrent ischemic stroke while taking aspirin",
recommend Byung-Chul Lee (Hallym University College of Medicine, South
Korea) and co-researchers.
They studied 310 patients who were admitted within 48 hours of acute
ischemic stroke onset and had been taking aspirin 100 mg/day for at
least 7 days before.
Aspirin resistance was seen in 86 (27.7%) patients, based on high
residual platelet reactivity (HRPR) of at least 550 on the VerifyNow
(Accumetrics, San Diego, California, USA) assay.
Stroke severity was significantly worse for these patients than for
those without aspirin resistance, with a median National Institutes of
Health Stroke Scale (NIHSS) score of 6 versus 3, supporting findings
from previous studies but in a larger sample size.
The researchers also used the diffusion-weighted imaging (DWI) to
clinically assess neurological deficits in the patients, finding that
those with aspirin resistance had significantly larger infarct volumes,
at a median 5.4 cm3 versus 1.7 cm3.
NIHSS scores and infarct volume remained significantly higher in
patients with aspirin resistance after taking into account age, gender
and other variables such as hypertension, antihypertensive drug use,
stroke type and delay in symptom onset to hospital arrival, with median
between group differences of 2.1 points and 2.3 cm3, respectively.
While
the study design ruled out conclusions regarding the cause and effect
relationship between HRPR and stroke severity and infarct volume, the
researchers found that the negative effects of aspirin resistance were
more apparent in patients with NIHSS scores and DWI infarct volumes in
the upper quantiles (50th, 75th and 90th) relative to lower ones (10th,
25th).
Therefore, "HRPR had a greater negative association with stroke severity in patients with greater thrombosis", they explain.
There was also evidence of a relationship between the preventive
effects of aspirin and the underlying stroke mechanism. Aspirin
resistance was significantly associated with higher NIHSS scores and
larger infarct volumes in patients with large-artery atherosclerosis and
those with stroke of other or undetermined aetiology, but not in those
with cardioembolic stroke or small vessel occlusion.
This suggests that aspirin resistance has a greater influence on
stroke severity in patients with atherosclerotic versus
nonatherosclerotic stroke, says the team.
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