Biochemical aspirin resistance is associated with increased stroke severity and infarct volumes in ischemic stroke patients

// Xuan Cheng 1 , Nan-Chang Xie 1 , Hong-Liang Xu 1 , Chen Chen 1 and Ya-Jun Lian 1 1 Department of Neurology, The first affiliated hospital of Zhengzhou University, Zhengzhou, Henan province, P.R. China Correspondence to: Ya-Jun Lian, email: lianyajun369@sina.com Keywords: aspirin resistance, infarct volume, stroke severity, diffusion-weighted imaging Received: May 16, 2017     Accepted: June 30, 2017     Published: August 18, 2017 ABSTRACT To explore the correlation of aspirin resistance (AR) with clinical stroke severity and infarct volume using diffusion-weighted imaging (DWI) in 224 Chinese ischemic stroke patients who were taking aspirin before stroke onset. In those patients, the median age was 64 years (IQR, 56-75 years), and males accounting for 54.9%(123)of the total subjects. Fifty of 224 enrolled patients (22.3%; 95% confidence interval (CI), 16.9% to 27.7%) showed AR. In the median regression model, significant increase was estimated in NIHSS score of 0.04 point for every 1-point increase in aspirin reaction units (ARU) (95% CI, 0.02 to 0.06; P <0.001). Diffusion-weighted MRI (DWI)-measured infarct volume were significantly higher in patients with AR as compared with those with AS [13.21 (interquartile ranges [IQR], 8.51-23.88) vs .4.26 (IQR, 1.74-11.62); P <0.001). Furthermore, a statistically significant increase was also measured in NIHSS score of 0.05 point for every 1-point increase in ARU in the median regression model (95% CI, 0.03 to 0.08; P <0.001). The median DWI infarct volume was significantly larger in the highest ARU quartile when compared to that in the low 3 quartiles (P<0.001). In conclusion, stroke patients with AR indicated higher risk of severe strokes and large infarcts compared to patients in the aspirin-sensitive group.