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Abstract Details

Prevalence of Antiplatelet Resistance in Patients with Noncardioembolic Stroke
Cerebrovascular Disease and Interventional Neurology
P1 - Poster Session 1 (8:00 AM-9:00 AM)
5-004
This study was designed to evaluate the prevalence of inadequate antiplatelet to aspirin and clopidogrel in the setting of chronic use and presentation with primary or recurrent stroke. 

Currently there is not sufficient data regarding the prevalence of resistance, or inadequate platelet function inhibition, with the use of antiplatelet therapy in patients with noncardioembolic stroke.

Patients who were taking aspirin, clopidogrel, or both at the time of presentation for stroke were selected in this study. Those with confirmed stroke on MRI or clinically determined TIA and age >18 years were included. A standard laboratory test- VerifyNow aspirin or P2Y12 assay was utilized to assess the responsiveness to the platelet inhibitors. A total of 158 patients were identified, 52 presenting with primary stroke and 106 with recurrent stroke. Data was analyzed using Chi-squared or Fishers’ Exact as well as T-test analysis. 

Of the primary stroke population, 4% of patients demonstrated resistance to aspirin and 29% to clopidogrel. Of the patients presenting with recurrent stroke, 13% demonstrated resistance to aspirin and 38% to clopidogrel. The data also suggests increased resistance to aspirin and clopidogrel in Caucasians compared to minorities with 11% versus 0.8% in regard to aspirin and 32% versus 1% to clopidogrel. Additionally, this study demonstrated 16% resistance to aspirin in males compared to 0.7% in females, and 12% compared to 38% respectively regarding resistance to clopidogrel. No difference of inactivity to either aspirin or clopidogrel was detected between patients with small or large vessel disease.

The present result suggests a sizeable portion of the population has inefficacious activity in the setting of certain antiplatelet agents. Additionally, sex and ethnicity differences in responsiveness to aspirin or clopidogrel have been noted. Further studies of larger scale will need to apply this information to pursue individualized treatment. 
Authors/Disclosures
Jiangyong Min, MD (Corewell Health West)
PRESENTER 		Dr. Min has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Medtronic . Dr. Min has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for CredentialMed, LLC. The institution of Dr. Min has received research support from Corerwell Health Foundation .
Samantha R. Cencer, DO (Spectrum Health) Dr. Cencer has nothing to disclose.
Asad Ahrar, MD (Corwell Health) Dr. Ahrar has nothing to disclose.
Malgorzata Miller, MD (Corewell Health) The institution of Dr. Miller has received research support from NIH StrokeNet VERIFY trial.
Nadeem I. Khan, MD (Spectrum Health) Dr. Khan has nothing to disclose.
Nabil Wees, MD (Augusta University) Dr. Wees has nothing to disclose.
Laurel Packard (Corewell Health) Laurel Packard has nothing to disclose.