A Comparative Study of Dual versus Monoantiplatelet Therapy in Patients with Acute Large-Artery Atherosclerosis Stroke

Yi, Xingyang; Lin, Jing; Chün, Wang; Zhang, Biao; Chi, Wanzhang

doi:10.1016/j.jstrokecerebrovasdis.2014.01.022

Cited by 57 publications

(51 citation statements)

References 31 publications

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“…Intake of aspirin also significantly reduces PMA levels in stroke-recovering patients (91) and anti-platelet therapy is beneficial in the prevention of secondary stroke after cardiovascular events. Furthermore, in patients with large-artery atherosclerosis-induced stroke aspirin and clopidogrel together reduce platelet aggregation and PLA formation more efficiently than aspirin alone (92). These results indicate that inhibiting several platelet activation pathways might be beneficial in patients by limiting ischemic stroke recurrence and neurologic deterioration.…”

Section: Platelet-leukocyte Interactions In Pathologic Conditionsmentioning

confidence: 99%

Measuring and interpreting platelet-leukocyte aggregates

et al. 2018

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Platelets, besides their specialised role in haemostasis and atherothrombosis, actively modulate innate and adaptive immune responses with crucial roles in immune surveillance, inflammation and host defence during infection. An important prerequisite for platelet-mediated changes of immune functions involves direct engagement with different types of leukocytes. Indeed, increased platelet-leukocyte aggregates (PLAs) within the circulation and/or locally at the site of inflammation represent markers of many thrombo-inflammatory diseases, such as cardiovascular diseases, acute lung injury, renal and cerebral inflammation. Therefore, measurement of PLAs could provide an attractive and easily accessible prognostic and/or diagnostic tool for many diseases. To measure PLAs in different (patho-)physiological settings in human and animal models flow cytometric and microscopic approaches have been applied. These techniques represent complementary tools to study different aspects relating to the involvement of leukocyte subtypes and molecules, as well as location of PLAs within tissues, dynamics of their interactions and/or dynamic changes in leukocyte and platelet behaviour. This review summarises various approaches to measure and interpret PLAs and discusses potential experimental factors influencing platelet binding to leukocytes. Furthermore, we summarise insights gained from studies regarding the underlying mechanism of platelet-leukocyte interactions and discuss implications of these interactions in health and disease.

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Section: Platelet-leukocyte Interactions In Pathologic Conditionsmentioning

confidence: 99%

Measuring and interpreting platelet-leukocyte aggregates

et al. 2018

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“…Platelet aggregation was measured by light transmittance aggregometry (LTA), as described previously [2, 5, 18]. A mean aggregation of ≥70% with 10 μM ADP and a mean aggregation of ≥20% with 0.5 mM AA after aspirin intake for 7 to 10 days were defined as AR.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Early neurological deterioration (END) and recurrent ischemic stroke (ERIS) are common and are associated with poor prognosis in acute ischemic stroke (IS) patients [2]. Aspirin is routinely used for the treatment of IS [3], and its use is associated with improved outcomes [2, 4]. However, recent studies have shown that aspirin resistance (AR) can lead to the failure of antiplatelet therapy [5], and is associated with frequent END and ERIS in patients with acute IS [6, 7].…”

Section: Introductionmentioning

confidence: 99%

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Interaction among COX-2, P2Y1 and GPIIIa gene variants is associated with aspirin resistance and early neurological deterioration in Chinese stroke patients

Chün

Zhou

et al. 2017

BMC Neurol

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BackgroundThe effect of genetic variants on aspirin resistance (AR) remains controversial. We sought to assess the association of genetic variants with AR and early clinical outcomes in patients with acute ischemic stroke (IS).MethodsA total of 850 acute IS patients were consecutively enrolled. Platelet aggregation was measured before and after a 7–10 day aspirin treatment. The sequences of 14 variants of COX-1, COX-2, GPIb, GPIIIa, P2Y1 and P2Y12 were determined using matrix-assisted laser desorption/ionization time of flight mass spectrometry. Gene-gene interactions were analyzed using generalized multifactor dimensionality reduction (GMDR). The primary outcome was early neurological deterioration (END) within 10 days of admission. The secondary outcome was a composite of early recurrent ischemic stroke (ERIS), myocardial infarction (MI) and death within 10 days of admission.Results175 (20.6%) patients were AR, 45 (5.3%) were aspirin semi-resistant, 121 (14.2%) developed END, 17 (0.2%) had ERIS, 2 (0.2%) died, and 6 (0.7%) had MI. Single locus analysis indicated that only rs1371097 was associated with AR. However, GMDR analysis indicated that the following three sets of gene-gene interactions were significantly associated with AR: rs20417CC/rs1371097TT/rs2317676GG; rs20417CC/rs1371097TT/rs2317676GG; rs20417CC/rs1371097CT/rs2317676AG. END occurred significantly more frequently in patients with AR or high-risk interactive genotypes. Moreover, AR and high-risk interactive genotypes were independently associated with END.ConclusionSensitivity of IS patients to aspirin and END may be multifactorial and is not significantly associated with a single gene polymorphism. Combinational analysis may useful for further insight into the genetic risks for AR.

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“…Early neurologic exercise and recurrent ischemic stroke (IS) are common and are associated with poor prognosis in acute IS patients 2. Antiplatelet drugs, statins, and anti‐hypertensive drugs are the third cornerstone of stroke prevention.…”

Section: Introductionmentioning

confidence: 99%

Association of GPIa and COX‐2 gene polymorphism with aspirin resistance

Wang

Sun

Dong

et al. 2017

Clinical Laboratory Analysis

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ObjectiveThis study aimed to explore the association between GPIa, COX‐2 gene polymorphisms and aspirin resistance in the ischemic stroke patients from the southern part of Jiangsu province.MethodsIn all, 97 patients with acute ischemic stroke were enrolled in the study. GPIa gene polymorphism at 807C>T (rsl126643) locus and COX‐2 gene polymorphism at ‐765G>C (rs20417) locus were genotyped by PCR pyrosequencing technology. Patients were divided into the aspirin sensitivity (AS) group and aspirin resistance (AR) group according to the platelet aggregation rate. The relationship between the two gene polymorphisms and aspirin resistance was investigated and analyzed.ResultsThe distribution of the genotype (CC, CT, TT, CT + TT, and CC) and the frequency of allele T of GPIa gene at 807C>T locus were significantly different in AS and AR groups in female patients (P < .05). Logistic regression analysis showed that the genotype of CT+TT at 807C>T locus was significantly correlated with AR after adjustment for relative factors (P = .047, OR = 4.856, 95% CI: 1.020–23.108). There were no significant differences in the genotype distribution and allele frequency of the COX‐2 gene ‐765G>C site between two groups (P > .05).Conclusion GPIa gene polymorphism at 807C>T locus was associated with AR in Chinese Han females, and the expression of allele T increased the incidence of AR. The gene polymorphism of COX‐2 gene at ‐765G>C locus was not significantly correlated with AR.

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A Comparative Study of Dual versus Monoantiplatelet Therapy in Patients with Acute Large-Artery Atherosclerosis Stroke

Cited by 57 publications

References 31 publications

Measuring and interpreting platelet-leukocyte aggregates

Measuring and interpreting platelet-leukocyte aggregates

Interaction among COX-2, P2Y1 and GPIIIa gene variants is associated with aspirin resistance and early neurological deterioration in Chinese stroke patients

Association of GPIa and COX‐2 gene polymorphism with aspirin resistance

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