신속혈소판기능검사를 이용한 허혈성 뇌졸중 환자에서 아스피린 저항성의 빈도와 관련인자 - 예비연구

Abstract

Background: Ischemic stroke may recur in many patients of previous ischemic events despite of taking antiplatelet drugs for secondary prevention of ischemic stroke. However, the proper laboratory test for monitoring antiplatelet therapy is not available in clinical situation. The rapid platelet function analyzers (RPFA) has been recently developed and used. The purposes of this study were to determine the frequency of aspirin resistance in patients with ischemic stroke and to identify the factors related with aspirin resistance using RPFA. Methods: We consecutively enrolled 81 patients taking aspirin regularly for secondary prevention of ischemic stroke. Demographic data, vascular risk factors (hypertension, diabetes, hyperlipidemia), drug history, hemoglobin and platelet count were recorded. We used the VerifyNow￠c-Aspirin (Ultegra￠c RPFA-ASA, Accumetric Inc., San Diego, CA) to measure the inhibition of platelet function by aspirin. Results: Seven patients (8.6%) were identified as aspirin-non-responders on the platelet function test. Two patients who had taken aspirin medication prior to ischemic events showed insufficient platelet inhibition on the blood test. There was no significant difference between aspirin-responders and aspirin-non-responders concerning age, gender, hypertension, diabetes mellitus, hyperlipidemia, hemoglobin, and platelet count. The aspirin formula, dose and duration of treatment were not significantly different between the two groups. Conclusions: Aspirin resistance in ischemic stroke patients is not uncommon. The clinical usefulness of routine platelet function tests needs to be further study.