Clinical and biochemical aspirin resistance in patients with recurrent cerebral ischemia

El‐Mitwalli, Ashraf; Azzam, Hanan; Abu-Hegazy, Mohammad; Gomaa, Mohamed; Wasel, Yasser

doi:10.1016/j.clineuro.2012.09.025

Cited by 12 publications

(18 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Regarding other risk factors of stroke as smoking, diabetes, hypertension, dyslipideamia, migraine, obesity, obstructive sleep apnea and contraceptive pills, there was no significant difference between the two groups in our study and this is in agreement with Santos et al [12] and El-Mitwalli et al [11]; On the other hand Zheng et al [13] in his study found that smoking was significantly higher in patients with aspirin resistance, this may be due to different sample size and different methodology in their study as they did not exclude cardioembolic strokes.…”

Section: Discussionsupporting

confidence: 83%

“…The present study showed that there was no statistically significant difference between the two groups regarding age and sex and this is in accordance with Ozben et al [9] while El-Mitwalli et al [11] found that aspirin resistance was significantly higher in males and older age.…”

Section: Discussionsupporting

confidence: 82%

“…El-Mitwalli et al [11] also had the same opinion that argued about the effect of AR on NIHSS and reported that there was no significant difference between the resistant and sensitive groups of patients.…”

Section: Discussionmentioning

confidence: 78%

“…On the contrary Ozben et al [9] and El-Mitwalli et al [11] found that previous stroke was not a significant factor aspirin resistance in their studies…”

Section: Discussionmentioning

confidence: 81%

“…They attributed this to the fact of inability to reduce carotid mural thrombi, platelets inhibition failure and platelets microaggregate Increase of neurotoxic substance and larger cerebral tissue ischemia may lead to prothrombotic inflammatory reaction and incomplete response to aspirin Zheng et al [13]. On the other hand, El-Mitwalli et al [11] and Taekim et al [20] reported that lacunar infarcts were more prevelant in AR patients as they did not exclude patients with atrial fibrillation.…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Aspirin Resistance in Acute Ischemic Non-cardioembolic Stroke: Frequency and Clinical Study

Altaweel¹,

Kamel²,

Lotfy³

et al. 2017

IJCEN

View full text Add to dashboard Cite

Platelet activation in cerebrovascular diseases is associated with recurrent stroke and death. Aspirin is an effective antiplatelet agent, exhibiting its action by irreversibly inhibiting platelet cyclooxygenase-1 enzyme, thus preventing the production of thromboxane A 2 (TXA 2 ). Objectives: The study is designed to find the frequency of aspirin resistance (AR) among acute ischemic non-cardioembolic stroke patients, and to assess the clinical picture of those patients. Mehtods: This study included 80 patients39 males and 41 females (mean age: 63 years ± 11.8 SD), they were diagnosed clinically and via brain imaging within 24 hours following stroke onset. They were given non coated, same preparation of aspirin 150 mg/day regularly and under observation, Low molecular weight heparin 40 mg per day. The patients were followed up clinically and via GCS, NIHSS and APACHEII scales. Assessment of aspirin resistance was done one week after regular aspirin intake through: bleeding time, coagulation time and assessment of thromboxaneA2 level in serum using ELIZA. The patients were classified into two groups aspirin resistant (AR) and aspirin sensitive (AS) and the data were compared in both. Results: AR patients represented 33.75% of our sample. History of TIAs and stroke was more prevalent among them. In AR patients: the followings were also more frequent: more affection of consciousness, power, sensation, language, coordination, vertigo, vomiting, large size of cerebral infarcts, temporal and parietal infarcts. There were high significant negative correlation between GCS and TXA2level and between the later and changes in bleeding time in the first day and 7 days following stroke onset. On the other hand there were high positive correlation between TXA2 level and NIHSS score and infarct size. Coclusion: AR was frequent among ischemic non-cardioembolic stroke and they were associated with history of TIAs and previous strokes, and presented with more severe clinical presentation and larger size of cerebral infarcts, So early identification of AR prevents its fruitless use.

show abstract

Section: Discussionsupporting

confidence: 83%

Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 78%

“…On the contrary Ozben et al [9] and El-Mitwalli et al [11] found that previous stroke was not a significant factor aspirin resistance in their studies…”

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Aspirin Resistance in Acute Ischemic Non-cardioembolic Stroke: Frequency and Clinical Study

Altaweel¹,

Kamel²,

Lotfy³

et al. 2017

IJCEN

View full text Add to dashboard Cite

show abstract

Platelet function‐guided antiplatelet therapy in stroke prevention

Wiśniewski

2021

Prog Neurol Psychiatry

View full text Add to dashboard Cite

Antiplatelet agents, including aspirin and clopidogrel, remain the primary therapeutic options for secondary prevention of ischaemic non‐embolic stroke. The effectiveness of the applied therapy and the appropriate choice of agent is of key importance to subjects after stroke, contributing to minimising the risk of recurrent vascular events. However, the efficacy of antiplatelet agents is variable and in many cases definitely insufficient.

show abstract

Burden of Stroke in Egypt: Current Status and Opportunities

Abd-Allah

Moustafa

2014

International Journal of Stroke

View full text Add to dashboard Cite

Middle East and North Africa (MENA) countries have a diversity of populations with similar life style, dietary habits, and vascular risk factors that may influence stroke risk, prevalence, types, and disease burden. Egypt is the most populated nation in the Middle East with an estimated 85.5 million people. In Egypt, according to recent estimates, the overall prevalence rate of stroke is high with a crude prevalence rate of 963/100,000 inhabitants. In spite of disease burden, yet there is a huge evidence practice gap. The recommended treatments for ischemic stroke that are guideline include systematic supportive care in a stroke unit or stroke center is still deficient. In addition, the frequency of thrombolysis in Egypt is very low for many reasons; the major one is that the health insurance system is not covering thrombolysis therapy in nonprivate sectors so patients must cover the costs using their own personal savings; otherwise, they will not receive treatment. Another important factor is the pronounced delay in prehospital and in hospital management of acute stroke. Improvement of stroke care in Egypt should be achieved through multi and interdisciplinary approach including public awareness, physicians' education, and synergistic approach to stroke care with Emergency Medical System.

show abstract

Clinical and biochemical aspirin resistance in patients with recurrent cerebral ischemia

Cited by 12 publications

References 30 publications

Aspirin Resistance in Acute Ischemic Non-cardioembolic Stroke: Frequency and Clinical Study

Aspirin Resistance in Acute Ischemic Non-cardioembolic Stroke: Frequency and Clinical Study

Platelet function‐guided antiplatelet therapy in stroke prevention

Burden of Stroke in Egypt: Current Status and Opportunities

Contact Info

Product

Resources

About