PMID- 35372727
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220405
IS  - 2455-4626 (Electronic)
IS  - 2394-8108 (Print)
IS  - 2394-8108 (Linking)
VI  - 8
IP  - 1
DP  - 2022 Jan-Mar
TI  - Aspirin resistance and blood biomarkers in predicting ischemic stroke recurrence: 
      An exploratory study.
PG  - 31-37
LID - 10.4103/bc.bc_75_21 [doi]
AB  - BACKGROUND: Recurrent strokes cause greater complications and worse outcomes by 
      adding to the existing neurological deficit. There is the paucity of data on 
      serum markers of inflammation as predictors of recurrent stroke. This study was 
      planned to analyze the clinico-etiological profile of recurrent noncardioembolic 
      ischemic stroke, estimate aspirin resistance among regular aspirin users and 
      evaluate blood biomarkers high-sensitivity C-reactive protein (hsCRP), Tumor 
      necrosis factor-alpha (TNF-alpha), Lipoprotein-associated phospholipase A(2) 
      (Lp-PLA2) as probable predictors of stroke recurrence. METHODS: Patients of 
      recurrent noncardioembolic ischemic stroke fulfilling the inclusion criteria were 
      enrolled. Detailed history, clinical examination, and investigations were 
      obtained as per protocol. Aspirin resistance was determined by light transmission 
      aggregometry. Serum hsCRP, TNF-alpha, and Lp-PLA2 levels were estimated. RESULTS: 
      This study included 34 males and 16 females. Majority of the patients were > 60 
      years (n = 30, 60%). Thirty (60%) cases had a repeat stroke after 1 year of 
      primary event. Thirty-nine (78%) study participants had hypertension, while 15 
      (30%) had diabetes. Middle cerebral artery (n = 40, 80%) was the most common 
      vascular territory. Thirty-one (62%) cases belonged to TOAST subtype 1 (large 
      artery atherosclerosis). Seventy two percent cases were prescribed aspirin after 
      index stroke, but only 36% were compliant. Median (range) hsCRP level was 7.5 
      (0.3-155) mg/L with 72% of patients having high hsCRP level (>3 mg/L). Median 
      (range) serum PLA2 level was 11.98 (3.31-87.24) ng/ml in patients and 6.96 
      (0.15-61.42) ng/ml in controls (P = 0.029). Median (range) serum TNF-alpha level in 
      patients was significantly higher than controls (68.22 [1.3-287] pg/ml versus 
      0.098 [0.002-36.31] pg/ml, P < 0.001). Aspirin resistance was found in 41.7% 
      patients while 16.7% were semi-resistant. Mean % platelet aggregation was 34.75 +/- 
      21.58 in patients and 64.75 +/- 16.98 for controls (P < 0.001). CONCLUSIONS: 
      Majority of patients with recurrent stroke were elderly (>60 years), 
      hypertensive, and non-compliant with aspirin. Aspirin resistance was an important 
      factor in patients with antiplatelet compliance. Inflammatory biomarkers hsCRP, 
      PLA2, and TNF-alpha were found to be significantly elevated in patients compared to 
      controls.
CI  - Copyright: (c) 2022 Brain Circulation.
FAU - Dash, Prerana
AU  - Dash P
AD  - Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, 
      Varanasi, Uttar Pradesh, India.
FAU - Singh, Varun Kumar
AU  - Singh VK
AD  - Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, 
      Varanasi, Uttar Pradesh, India.
FAU - Gautam, Deepa
AU  - Gautam D
AD  - Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, 
      Varanasi, Uttar Pradesh, India.
FAU - Pathak, Abhishek
AU  - Pathak A
AD  - Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, 
      Varanasi, Uttar Pradesh, India.
FAU - Kumar, Anand
AU  - Kumar A
AD  - Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, 
      Varanasi, Uttar Pradesh, India.
FAU - Mishra, Surendra Pratap
AU  - Mishra SP
AD  - Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu 
      University, Varanasi, Uttar Pradesh, India.
FAU - Dash, Debabrata
AU  - Dash D
AD  - Department of Biochemistry, Institute of Medical Sciences, Banaras Hindu 
      University, Varanasi, Uttar Pradesh, India.
FAU - Mishra, Vijay Nath
AU  - Mishra VN
AD  - Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, 
      Varanasi, Uttar Pradesh, India.
FAU - Joshi, Deepika
AU  - Joshi D
AD  - Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, 
      Varanasi, Uttar Pradesh, India.
FAU - Chaurasia, Rameshwar Nath
AU  - Chaurasia RN
AD  - Department of Neurology, Institute of Medical Sciences, Banaras Hindu University, 
      Varanasi, Uttar Pradesh, India.
LA  - eng
PT  - Journal Article
DEP - 20220321
PL  - India
TA  - Brain Circ
JT  - Brain circulation
JID - 101669876
PMC - PMC8973447
OTO - NOTNLM
OT  - Aspirin resistance
OT  - high-sensitivity C-reactive protein
OT  - lipoprotein-associated phospholipase A2
OT  - recurrent ischemic stroke
OT  - tumor necrosis factor alpha
COIS- Prerana Dash and Varun Kumar Singh share first authorship together because of 
      equal contribution. Rest there is no conflicts of interest among authors.
EDAT- 2022/04/05 06:00
MHDA- 2022/04/05 06:01
PMCR- 2022/03/21
CRDT- 2022/04/04 05:34
PHST- 2021/11/14 00:00 [received]
PHST- 2022/01/04 00:00 [revised]
PHST- 2022/01/19 00:00 [accepted]
PHST- 2022/04/04 05:34 [entrez]
PHST- 2022/04/05 06:00 [pubmed]
PHST- 2022/04/05 06:01 [medline]
PHST- 2022/03/21 00:00 [pmc-release]
AID - BC-8-31 [pii]
AID - 10.4103/bc.bc_75_21 [doi]
PST - epublish
SO  - Brain Circ. 2022 Mar 21;8(1):31-37. doi: 10.4103/bc.bc_75_21. eCollection 2022 
      Jan-Mar.