PREDICTORS OF ASPIRIN RESISTANCE IN PATIENTS WITH ISCHEMIC STROKE

Objective. To determine predictors of aspirin resistance among atherothrombotic ischemic stroke patients considering demographic and clinical characteristics.

Materials and Methods. We examined 100 patients with atherothrombotic stroke hospitalized to the

Regional Vascular Center (Yakutsk) in 2020-2021. Platelet aggregation measured by a computerized whole blood Multiplate aggregometer on the 5th-7th day after the acetylsalicylic acid therapy initiation. To search for predictors of the development of aspirin resistance, the examined group's clinical and demographic characteristics investigated.

Results. No relationship was found between the development of aspirin resistance and race (p=0.052). There was an association between the presence of diabetes mellitus and high aggregometry scores (p=0.042; OR=0.412; 95 % CI: 0.173-0.979). Smoking, alcohol abuse and previous stroke were not significant for the development of aspirin resistance (p = 0.585; p = 0.158; p = 0.656, respectively). High lipid spectrum values were also associated with the risk of developing aspirin resistance (p = 0.01 for CH, p = 0.034 for LDL, p = 0.021 for HDL). NIHSS stroke severity was not associated with the platelet aggregation scores (p=0.297 at admission and p=0.108 at discharge). Hepatopathies were statistically significantly related with the increasing platelet aggregation (p = 0.001; OR=0.123; 95 % CI: 0.032-0.471). A dose-dependent effect of antiaggregant therapy was found. Aspirin dose was inversely associated with platelet aggregation scores (p < 0.001; OR=0.318; 95 % CI: 0.234-0.432).

Conclusion. The findings prove the connection between the degree of platelet aggregation and diabetes mellitus. The liver diseases of various etiologies are aspirin resistance predictors. The dose of the prescribed antiplatelet directly affects the level of platelet aggregation. The phenomenon of aspirin resistance needs further research with the use of molecular genetic testing techniques.

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