The Difference in Aspirin Resistance Based on an Optical Platelet Aggregometer and the PFA-100 in Patients with Acute Ischemic Stroke
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background: There are many causes for the failure of aspirin therapy in patients with acute ischemic stroke. Laboratory aspirin resistance (AR) might be involved in clinical aspirin non-response. The PFA-100 is a laboratory method to evaluate AR in the clinical setting. However, there has been limited data regarding concordance with optical platelet aggregometry, which is considered the gold standard for detecting AR. We retrospectively analyzed platelet function tests using the PFA-100 and an optical platelet aggregometer in 86 patients with acute ischemic stroke. Methods: Eighty six patients were enrolled in the study and were evaluated the platelet function test by optical aggregometer and a PFA-100. We determined the variability in the prevalence of AR and the kappa value between the two tests in patients with acute ischemic stroke. Results: Among 86 patients, 27 (31.4%) were detected as AR by the optical aggregometer and 31 (36.0%) by the PFA-100 . There were 13 cases of AR (15.1%)in both laboratory methods. The optical platelet aggregometer results showed that female gender (P =0.03), aspirin monotherapy(P =0.05), and NIHSS at baseline (P =0.04) were related with AR in acute ischemic stroke. Multiple logistic regression analysis showed that NIHSS was independently associated with AR of the optical platelet aggregometer (OR=1.12 95%, CI: 1.00-1.25,P =0.05). Conclusion: The prevalence of AR was similar between the PFA-100 and the optical platelet aggregometer in patients with acute ischemic stroke. However, the concordance rate of these two tools is low. (Korean J Stroke 2011;13:114-119)
Abstract
Background: There are many causes for the failure of aspirin therapy in patients with acute ischemic stroke. Laboratory aspirin resistance (AR) might be involved in clinical aspirin non-response. The PFA-100 is a laboratory method to evaluate AR in the clinical setting. However, there has been limited data regarding concordance with optical platelet aggregometry, which is considered the gold standard for detecting AR. We retrospectively analyzed platelet function tests using the PFA-100 and an optical platelet aggregometer in 86 patients with acute ischemic stroke. Methods: Eighty six patients were enrolled in the study and were evaluated the platelet function test by optical aggregometer and a PFA-100. We determined the variability in the prevalence of AR and the kappa value between the two tests in patients with acute ischemic stroke. Results: Among 86 patients, 27 (31.4%) were detected as AR by the optical aggregometer and 31 (36.0%) by the PFA-100 . There were 13 cases of AR (15.1%)in both laboratory methods. The optical platelet aggregometer results showed that female gender (P =0.03), aspirin monotherapy(P =0.05), and NIHSS at baseline (P =0.04) were related with AR in acute ischemic stroke. Multiple logistic regression analysis showed that NIHSS was independently associated with AR of the optical platelet aggregometer (OR=1.12 95%, CI: 1.00-1.25,P =0.05). Conclusion: The prevalence of AR was similar between the PFA-100 and the optical platelet aggregometer in patients with acute ischemic stroke. However, the concordance rate of these two tools is low. (Korean J Stroke 2011;13:114-119)
참고문헌 (34)
- van Gijin J, Algra, "Aspirin and stroke prevention", Throm Res, 2, pp.517~523 (2003)
- Ferguson JJ, "The role of oral antiplatelet agents in atherothrombotic disease", Am J Cardiovasc Drugs, 6, pp.149~157 (2006)
- CAST, "Randomised placebo-controlled trial of early aspirin use in 20,000 patients with acute ischaemic stroke. CAST (Chinese Acute Stroke Trial) Collaborative Group", Lancet, 349, pp.1641~1649 (1997)
- The International Stroke Trial (IST), "A randomised trial of aspirin, subcutaneous heparin,both, or neither among 19435 patients with acute ischaemic stroke. International Stroke Trial Collaborative Group", Lancet, 349, pp.1569~1581 (1997)
- Liao JK, "Secondary prevention of stroke and transient ischemic attack: is more platelet inhibition the answer", Circulation, 115, pp.1615~1621 (2007)
- Mason PJ, "Aspirin resistance and atherothrombotic diseases", J Am Coll Cardiol, 46, pp.986~993 (2005)
- Sztriha LK, "Aspirin resistance in stroke", J Neurol Sci, 229, pp.163~169 (2005)
- Krasopoulos G, "Aspirin “resistance” and risk of cardiovascular morbidity: systematic review and meta-analysis", BMJ, 336, pp.195~198 (2008)
- Gurbel PA, "Platelet function monitoring in patients with coronary artery disease", J Am Coll Cardiol, 50, pp.1822~1834 (2007)
- Nicholson NS, "Assessment of platelet function assays", Am Heart J, 135, pp.S170~178 (1998)
- Jilma B, "Platelet function analyzer (PFA-100). A tool to quantify congenital or acquired platelet dysfunction", J Lab Clin Med, 138, pp.152~163 (2001)
- Favaloro EJ, "Clinical application of the PFA-100", Curr Opin Hematol, 9, pp.407~415 (2002)
- Reny JL, "Use of the PFA- 100 closure time to predict cardiovascular events in aspirin-treated cardiovascular patients: a systematic review and meta-analysis", J Thromb Haemost, 6, pp.444~450 (2008)
- Homoncik M, "Monitoring of aspirin (ASA) pharmacodynamics with the platelet function analyzer PFA-100", Thromb Haemost, 82, pp.316~321 (2000)
- Malinin AI, "Effect of a single dose of aspirin on platelets in humans with multiple risk factors for coronary artery disease", Eur J Pharmacol, 462, pp.139~143 (2003)
- Gum PA, "A prospective, blinded determination of the natural history of aspirin resistance among stable patients with cardiovascular disease", J Am Coll Cardiol, 41, pp.961~965 (2003)
- Jeon HW, "Factors related to progression of middle cerebral artery stenosis determined using transcranial Doppler ultrasonograhy", J Thromb Thrombolysis, 25, pp.265~269 (2008)
- Grau AJ, "Platelet function under aspirin, clopidogrel, and both after ischemic stroke: a casecrossover study", Stroke, 34, pp.849~854 (2003)
- Poulsen TS, "Prevalence of aspirin resistance in patients with an evolving acute myocardial infarction", Thromb Res, 119, pp.555~562 (2007)
- Antithrombotic Trialists’ Collaboration, "Collaborative metaanalysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients", BMJ, 324, pp.71~86 (2002)
- Marcucci P, "Usefulness of aspirin resistance after percutaneous coronary intervention for acute myocardial infarction in predicting one-year major adverse coronary events", Am J Cardiol, 98, pp.1156~1159 (2006)
- Grotemeyer KH, "Two-year follow-up of aspirin responder and aspirin non responder. A pilot study including 180 post-stroke patients", Thromb Res, 71, pp.397~403 (1993)
- Eikelboom JW, "Aspirin resistant thromboxane biosynthesis and the risk of myocardial infarction, stroke, or cardiovascular death in patients at high risk for cardiovascular events", Circulation, 105, pp.1650~1655 (2002)
- Cha JK, "ADP-induced platelet aggregation in acute ischemic stroke patients on aspirin therapy", Eur J Neurol, 15, pp.1304~1308 (2008)
- Boncoraglio GB, "Aspirin resistance determined with PFA-100 does not predict new thrombotic events in patients with stable ischemic cerebrovascular disease", Clin Neurol Neurosurg, 111, pp.270~273 (2009)
- Jeon SB, "Biochemical aspirin resistance and recurrent lesions in patients with acute ischemic stroke", Eur Neurol, 64, pp.51~57 (2010)
- Hankey GJ, "Aspirin resistance", Lancet, 367, pp.606~617 (2006)
- Gurbel PA, "Evaluation of dose-related effects of aspirin on platelet function: results from the Aspirin- Induced Platelet Effect (ASPECT) study", Circulation, 115, pp.3156~3164 (2007)
- Harrison P, "Screening for aspirin responsiveness after transient ischemic attack and stroke: comparison of 2 point-of-care platelet function tests with optical aggregometry", Stroke, 36, pp.1001~1005 (2005)
- Lee PY, "Low-dose aspirin increases aspirin resistance in patients with coronary artery disease", Am J Med, 118, pp.723~727 (2005)
- Englyst NA, "Aspirin resistance is more common in lacunar strokes than embolic strokes and is related to stroke severity", J Cereb Blood Flow Metab, 28, pp.1196~1203 (2008)
- Jae-KwanCha, "Surface Expression of P-selectin on Platelets Is Related with Clinical Worsening in Acute Ischemic Stroke", Journal of Korean Medical Science, 17(6), pp.811~816 (2002), 대한의학회
- Cha JK, "Changes in platelet P-selectin and in plasma C-reactive protein in acute atherosclerotic ischemic stroke treated with a loading dose of clopidogrel", J Thromb Thrombolysis, 14, pp.145~150 (2002)
- Christie DJ, "Hypersensitivity of platelets to adenosine diphosphate in patients with stable cardiovascular disease predicts major adverse events despite antiplatelet therapy", Platelets, 19, pp.104~110 (2008)
