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Many stroke, heart attack patients may not benefit from aspirin
Date:2/25/2008

istance and clinical aspirin failure, the UB/DENT study provided other data of clinical importance.

The researchers found that patients with coronary artery disease are more likely to be aspirin resistant, as well as patients with diabetes and those who suffered an earlier stroke, but not a transient ischemic attack (TIA), known as a mini-stroke.

However, they did not find a relationship between aspirin resistance and hypertension or high cholesterol in their study population. Gengo said this finding likely was due to the fact that patients at the Dent Neurologic Institute are from an affluent suburban population, and their hypertension and lipid levels tend to be extremely well controlled.

The study also found that the younger the patient when the first stoke or heart attack occurs, the higher the risk of being aspirin resistant.

You can think about that in a couple ways, noted Gengo. If you have a stroke when youre 50, you probably have much worse vascular disease than the patient who has a stroke at 70, so you are more likely to be aspirin resistant on that basis.

Also, the younger you are the faster you turn your platelets over, he said. If you are making platelets faster, you may need more aspirin, and the faster you make them, the faster youre going to overwhelm the aspirin. We dont really know for sure, but we speculate the higher risk factor in our younger patients is based on one of those two reasons.

The findings in the paper need to be confirmed in a larger study population followed over 1-2 years, Gengo stated. In the meantime, he suggested that clinicians could test a patients responsiveness to aspirin early on and prescribe accordingly.


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Contact: Lois Baker
ljbaker@buffalo.edu
716-645-5000 x1417
University at Buffalo
Source:Eurekalert

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