Abstract Details

Title PIAST - Platelet Inhibition Assessment in Stroke Trial - The Assessment of Efficacy of Platelet Aggregation Inhibition in Stroke Patients with the Multiplate Analyzer, a Point-of-Care Method

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P02 - (-)

Poster/Presentation
Number 055

Objective

Background BACKGROUND: A not insignificant number of patients suffer from a recurrent cerebral ischemia despite treatment with AM without detectable progression of the underlying illness. This could be based on antiplatelet non-responsiveness caused by different factors. With the aid of a POC assay we analyzed platelet function to identify the effects of antiplatelet therapy in stroke patients. Furthermore, the question if insufficient aspirin related platelet inhibition has prognostic value for the clinical outcome is addressed.

Design/Methods DESIGN/METHODS: We analyzed the platelet function of 456 patients admitted with a suspected stroke either already prior being treated with aspirin, clopidogrel or aspirin + dipyridamole or being newly placed on aspirin monotherapy with the aid of MEA. The tests were performed within two days but earliest 1 day after aspirin ingestion.

Results RESULTS: Data shows that altogether 139 (30.4%) of the examined patients with suspected ischemic stroke fall into the category of potential resistance to antiplatelet agents. Thereof 301 patients had confirmed strokes by MRI, and the remaining 155 patients were initially considered as TIA. Of the 402 cerebral ischemia patients 30.8% (124) showed likely resistance to aspirin or other AM. A small population (36) treated with clopidogrel and with aspirin + dipyridamole (17) showed 14% respectively 29% values compatible with resistance. In the confirmed stroke group in 28.2% of the patients aspirin was newly adjusted in the regimen.

Conclusions CONCLUSIONS: This trial demonstrates that nearly 1/3 of cerebral ischemia patients are potential aspirin nonresponders, which might have significant implications in the medical treatment of stroke patients.

Authors/Disclosures
PRESENTER	No disclosure on file
	No disclosure on file
	No disclosure on file
	No disclosure on file
Daniel Ontaneda, MD, PhD, FAAN (Cleveland Clinic)	Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Genentech/Roche. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen Idec. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Dr. Ontaneda has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sanofi. The institution of Dr. Ontaneda has received research support from NIH. The institution of Dr. Ontaneda has received research support from PCORI. The institution of Dr. Ontaneda has received research support from NMSS. The institution of Dr. Ontaneda has received research support from Genetech.

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