Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 1.736
5-Year Impact Factor – 2.135
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MEiN – 70 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
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Advances in Clinical and Experimental Medicine

2010, vol. 19, nr 5, September-October, p. 593–599

Publication type: original article

Language: English

Aspirin Responsiveness in Ischemic Stroke Patients in Relation to Diabetes Mellitus, Lipid and Hemostatic Profile

Odpowiedź na aspirynę w niedokrwiennym udarze mózgu w odniesieniu do cukrzycy, profilu lipidowego i profilu hemostazy

Anna B. Sobol1,, Krzysztof Selmaj2,, Alina Mochecka2,, Anna Kumor3,, Jerzy Loba1,

1 Department of Internal Medicine and Diabetology, Medical University of Lodz, Poland

2 Department of Neurology, Medical University of Lodz, Poland

3 Department of Laboratory Diagnostics, Medical University of Lodz, Poland

Abstract

Background. The problem of aspirin responsiveness in ischemic stroke patients is still not clear.
Objectives. The aim of the study was to assess aspirin responsiveness in stroke patients in relation to diabetes mellitus, hemostatic and lipid profile.
Material and Methods. 64 patients (22 with diabetes, 41 men, mean age 57.9 ± 10.4 years) with ischemic stroke or transient ischemic attack treated with the routine dose of 150 mg acetylsalicylic acid (ASA) daily were included into this study. Aspirin responsiveness was assessed based on platelet reactivity using platelet function analyzer (PFA-100TM) with collagen/epinephrine cartridges and whole blood platelet aggregometry with 0.5 mM arachidonic acid on the first day of acute stroke and after 10 days of a 150 mg ASA intake. Lipid and hemostatic profiles were determined.
Results. The authors observed ASA unresponsiveness in 6/22 (27.3%) of diabetic and in 17/42 (40.5%) of non-diabetic patients (no significant differences). Lipoprotein(a) was higher in ASA-unresponsive compared with ASA-responsive patients – before ASA treatment 43 (4–102) mg/dl vs. 27 (4–130) mg/dl, p = 0.03 as well after 10 days of ASA treatment 37 (4–94) mg/dl vs 27 (1–90) mg/dl, p = 0.01.
Conclusion. The authors suggest that the prevalence of diabetes mellitus and hemostatic profile in ischemic stroke patients should not be associated with ASA unresponsiveness. The enhanced lipoprotein(a) might indicate ASA-unresponsive stroke patients.

Streszczenie

Wprowadzenie. Problem odpowiedzi na aspirynę u pacjentów z niedokrwiennym udarem mózgu pozostaje niewyjaśniony.
Cel pracy. Ustalenie, czy odpowiedź na aspirynę ma związek z występowaniem cukrzycy, profilem lipidowym i wskaźnikami hemostazy.
Materiał i metody. Badaniami objęto 64 pacjentów (22 chorych na cukrzycę, 41 M, średnia wieku 57,9 ± 10,4 lat) z niedokrwiennym udarem mózgu lub przejściowym atakiem niedokrwiennym (TIA), leczonych rutynową dawką 150 mg kwasu acetylosalicylowego (ASA) dziennie. Odpowiedź na aspirynę oceniano, badając reaktywność płytek krwi z wykorzystaniem analizatora czynności płytek krwi (PFA-100TM), z użyciem kartridży kolagen/epinefryna i na podstawie pomiaru agregacji we krwi pełnej z 0,5 mM kwasem arachidonowym w pierwszym dniu wystąpienia udaru i po 10 dniach przyjmowania 150 mg ASA. Oceniano profil lipidowy i wybrane wskaźniki hemostazy.
Wyniki. Brak odpowiedzi na ASA stwierdzono u 6 (27.3%) spośród 22 pacjentów chorych na cukrzycę i u 17 (40,5%) spośród 42 pacjentów niechorujących na cukrzycę (różnice nieistotne statystycznie). Lipoproteina (a) była wyższa u pacjentów nieodpowiadających na ASA w porównaniu z pacjentami odpowiadającymi na ASA zarówno przed leczeniem: 43 (4 – 102) mg/dl vs 27 (4–130) mg/dl, p = 0,03, jak i po 10 dniach leczenia ASA: 37 (4–94) mg/dl vs 27 (1–90) mg/dl, p = 0,01.
Wnioski. Badania mogą sugerować, że obecność cukrzycy, a także profil hemostazy u pacjentów z niedokrwiennym udarem mózgu nie są związane z brakiem odpowiedzi na ASA. Zwiększone stężenie lipoproteiny(a) może wskazywać pacjentów z niedokrwiennym udarem mózgu nieodpowiadających na ASA.

Key words

aspirin responsiveness, blood coagulation, diabetes mellitus, ischemic stroke, lipoprotein(a)

Słowa kluczowe

odpowiedź na aspirynę, krzepnięcie krwi, cukrzyca, niedokrwienny udar mózgu, lipoproteina (a)

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