| Objectives:To investigate the association of aspirin resistance(AR)with the plasma4-hydroxynonenal(4-HNE)level and its impact on recurrent cerebral infarction in patients with acute cerebral infarction(ACI)who were receiving aspirin therapy.Methods: One hundred and fifty-four ACI patients who previously received aspirin therapy(100 mg/d)were enrolled in the Neurology Department of our hospital from October 2017 to October 2018.Whole urine(for measuring the 11dhTXB2 level)along with blood(for measuring the plasma 4-HNE level)were collected at least seven days after the patients received aspirin.A cutoff of 1500pg/mg of 11dhTXB2/creatinine was used to determine AR.A follow-up period to monitor recurrence CI events was 1 year.In addition,blood testing was performed when the patients were first admitted to hospital.Results:1.Forty-six of the 154 enrolled patients(29.9%)were found to be AR.No statistical difference in age,sex,hypertension,diabetes mellitus,coronary disease,smoking status,NIHSS score,toast classification,platelet count,thrombocytocrit,LDL-C,HDL-C,TG,and TC was found between the AR and aspirin sensitive(AS)patients.2.The plasma 4-HNE level was found to be higher in the AR patients than AS patients(P <0.05).3.Mutiple logistic regression analysis showed that the 4-HNE level was associated with a higher risk of AR(OR = 1.041;95% CI 1.015-1.067;P < 0.05).4.ROC curve suggested that plasma 4-HNE level in patients with acute cerebral infarction could be used to predict the occurrence of AR[0.637(95% CI,0.584-0.725)](P<0.05).5.Spearman correlation analysis and corresponding scatter plots suggested that11dhTXB2 level in urine was positively correlated with plasma 4-HNE level(P < 0.01).6.1 year follow-up showed that AR was more prevalent in patients with recurrent CI [26(56.6%)] than those without [20(43.5%)](P < 0.001).Conclusions: The plasma 4-HNE level is strongly associated with AR and ACI patients with AR have a greater risk of recurrent CI. |
