Risk Factors Of Aspirin Resistance And Progressive Ischemic Stroke

Objective:Thromboelastogram was used to predict aspirin resistance;To explore the risk factors of aspirin resistance and progressive ischemic stroke;To explore the relationship between aspirin resistance and progressive ischemic stroke.Method:A retrospective study of 154 patients with ischemic stroke confirmed by cranial magnetic resonance imaging(MRI)or computed tomography(CT)scan was performed in the first affiliated hospital of nanchang university from January 2018 to January 2019.After prescription of 100 mg aspirin/day for 7 days,the blood sample was drawn and the platelet aggregation was measured by thromboelastogram.According to the thromboelastogram AA(arachidonic acid,AA)inhibition rate,the AA inhibition rate < 50% was aspirin resistant(Aspirin resistance,AR)group,and50% < AA inhibition rate < 100% was aspirin sensitive(Aspirin sensitivity,AS)group.According to the NIHSS score of patients at onset and 7 days after onset,the increase of ? 2 was divided into the progressive ischemic stroke group,and the increase of < 2 was divided into the non-progressive ischemic stroke group.All statistical analysis was performed using SPSS 25.0 statistical software.The incidence rate of AR and the difference in clinical indexes were analyzed.Logistic regression analysis was applied for the risk factors of AR and PIS.Results:122 patients with aspirin sensitivity and 32 patients with aspirin resistance.There was no significant difference in age,smoking,history of diabetes,history of valvular heart disease,history of stroke,taking proton pump inhibitors,admission systolic pressure,diastolic blood pressure,triglycerides,high-density lipoprotein cholesterol,homocysteine,creatinine,platelet count,mean platelet volume,hemoglobin,red blood cells deposited,fasting glucose,glycosylated hemoglobin and glycosylated serum protein between the AR group and AS group(P>0.05).The ARgroup were higher than AS group in the History of hypertension,History of carotid atherosclerosis,history of antihypertensive medication,uric acid,total cholesterol,LDL-c,and there was statistically significant difference between two groups(P<0.05).Logistic regression analysis showed that the risk factors influencing response to the AR were hyperuricemia and hypercholesterolemia.There was no significant difference in SIP between the AR group and AS group.There was no significant difference in the above clinical data between The progressive ischemic stroke group and the non-progressive ischemic stroke group(P>0.05).The progressive ischemic stroke group were higher than non-progressive ischemic stroke group in the FPG,and there was statistically significant difference between two groups(P<0.05).Logistic regression analysis showed that the risk factors influencing response to the PIS is hyperglycemia.There was no significant difference in the Angle and MA between The progressive ischemic stroke group and the non-progressive ischemic stroke group(P>0.05).The progressive ischemic stroke group were less than non-progressive ischemic stroke group in the R and K,and there was statistically significant difference between two groups(P<0.05).Conclusion:1.A certain number of patients with ischemic stroke fail to meet the desired platelet inhibition rate after taking aspirin.2.Hyperuricemia,hypercholesterolemia,high LDL-c,female,history of hypertension,History of carotid atherosclerosis,history of antihypertensive medication,were risk factors for aspirin resistance;Hyperuricemia and hypercholesterolemia were independently associated with aspirin resistance.3.Hyperglycemia is a risk factor for progressive ischemic stroke.Hyperglycemia independently associated with progressive ischemic stroke.4.The R and K values in TEG were as predictors of progressive ischemic stroke.