High on treatment platelet reactivity to aspirin and clopidogrel in ischemic stroke: A systematic review and meta-analysis

@article{Fiolaki2017HighOT,
  title={High on treatment platelet reactivity to aspirin and clopidogrel in ischemic stroke: A systematic review and meta-analysis},
  author={Aidonio Fiolaki and Aristeidis H. Katsanos and Athanassios P Kyritsis and Styliani Papadaki and Maria Kosmidou and Iraklis C. Moschonas and Alexandros D. Tselepis and Sotirios Giannopoulos},
  journal={Journal of the Neurological Sciences},
  year={2017},
  volume={376},
  pages={112-116}
}
High on-clopidogrel platelet reactivity in ischaemic stroke or transient ischaemic attack: Systematic review and meta-analysis.
Secondary Stroke Prophylaxis with Clopidogrel Produces Sufficient Antiplatelet Response.
Effectiveness of Platelet Function Analysis-Guided Aspirin and/or Clopidogrel Therapy in Preventing Secondary Stroke: A Systematic Review and Meta-Analysis
TLDR
The two studies showed opposite effects of PFA-guided ATM on the recurrent strokes in aspirin non-responders, leading to an insignificant difference in the subgroup meta-analysis.
The Phenomenon of Clopidogrel High On-Treatment Platelet Reactivity in Ischemic Stroke Subjects: A Comprehensive Review
TLDR
Several important predictors contributing to clopidogrel resistance were identified, including genetic polymorphisms, the concomitant use of other drugs, or vascular risk factors, in particular nonsmoking and diabetes.
High On-Treatment Platelet Reactivity in Danish Hyper-Acute Ischaemic Stroke Patients
TLDR
The recognition of HTPR to specific anti-platelet agents in the hyper-acute phase after stroke may be the first step toward interventions that may further minimize the early recurrent stroke risk.
Platelet function/reactivity testing and prediction of risk of recurrent vascular events and outcomes after TIA or ischaemic stroke: systematic review and meta-analysis
TLDR
Antiplatelet–HTPR may predict risks of recurrent vascular events/outcomes in CVD patients and further prospective, multi-centre studies are warranted.
Enhanced Platelet Reactivity under Aspirin Medication and Major Adverse Cardiac and Cerebrovascular Events in Patients with Coronary Artery Disease
TLDR
Patients with MACCE, death, and NSTEMI show enhanced platelet reactivity despite aspirin medication as compared to patients without ischemic events, which means insufficient response to aspirin medication should be regarded as risk factor for isChemic events in CAD patients.
Antiplatelet Resistance in Patients with Atherosclerosis
TLDR
It is indicated that diabetes mellitus and an elevated level of lipoproteins could be risk factors for aspirin or clopidogrel resistance in patients with cerebrovascular diseases.
Platelet function-guided modification in antiplatelet therapy after acute ischemic stroke is associated with clinical outcomes in patients with aspirin nonresponse
TLDR
In patients with aspirin nonresponse, platelet function-guided modification in antiplatelet therapy after an isChemic stroke was associated with significantly lower rate of ischemic events.
A Combination of Aspirin and Clopidogrel Predict More Favorable Dynamics of Platelet Reactivity versus Clopidogrel Alone in the Acute Phase of Minor Stroke
TLDR
The findings confirm the usefulness of dual antiplatelet therapy in minor strokes and support the continuation of the secondary prevention with clopidogrel alone rather than aspirin, particularly among identified beneficiaries of such a strategy.
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It is shown that patients biochemically identified as having laboratory aspirin resistance are more likely to also have "clinical resistance" to aspirin because they exhibit significantly higher risks of recurrent cardiovascular events compared with patients who are identified as (laboratory) aspirin sensitive.
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The prevalence of nonresponsiveness to aspirin was statistically higher in those patients who suffered recurrent cerebral ischemia while taking aspirin compared with patients who remained without new ischemic symptoms.
Early Dual Versus Mono Antiplatelet Therapy for Acute Non-Cardioembolic Ischemic Stroke or Transient Ischemic Attack: An Updated Systematic Review and Meta-Analysis
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For patients with acute noncardioembolic ischemic stroke or TIA, dual therapy was more effective than monotherapy in reducing risks of early recurrent stroke.
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Patients who are resistant to aspirin are at a greater risk of clinically important cardiovascular morbidity long term than patients who are sensitive to aspirin.
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A significant proportion of patients taking low-dose aspirin or enteric-coated aspirin have normal platelet function as measured by the PFA-100 test, which has broad implications in determining how aspirin is used and monitored.
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TLDR
Six major platelet function tests are not equally effective in measuring aspirin's antiplatelet effect and correlate poorly amongst themselves, and the clinical usefulness of the different assays to classify correctly patients as aspirin resistant remains undetermined.
Aspirin Resistance in the Acute Stages of Acute Ischemic Stroke Is Associated with the Development of New Ischemic Lesions
TLDR
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Aspirin Resistance in Chinese Stroke Patients Increased the Rate of Recurrent Stroke and other Vascular Events
TLDR
Aspirin resistance is common in Chinese patient taking antiplatelet medications and diabetes and high LDL may induce platelet activation and thrombosis and increase the occurrence of aspirin resistance.
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