Effect of prediabetes on asprin or clopidogrel resistance in patients with recent ischemic stroke/TIA
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ORIGINAL ARTICLE
Effect of prediabetes on asprin or clopidogrel resistance in patients with recent ischemic stroke/TIA Weili Jia 1,2,3,4 & Qian Jia 1,2,3,4
&
Yumei Zhang 1,2,3,4,5 & Xingquan Zhao 1,2,3,4 & Yongjun Wang 1,2,3,4
Received: 29 April 2020 / Accepted: 4 November 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Objective Diabetes mellitus (DM) had been discovered as an independent risk factor for high on-treatment platelet reactivity (HPR) in patients with ischemic stroke. However, studies on the relationship between prediabetes and the occurrence of HPR remain scarce. This study is aimed at clarifying the association between prediabetes and HPR among patients with recent ischemic stroke or transient ischemic stroke (TIA). Methods Patients with ischemic stroke or TIA within 90 days after onset were recruited consecutively. All patients were divided into three groups: DM, prediabetes, and normal glucose tolerance according to fasting glucose, HbA1c, or OGTT. Three months later, all patients were performed platelet aggregation inhibition test and screened for high on-treatment platelet reactivity. The effect of prediabetes on HPR was analyzed in a multivariable logistic regression model. Results This study recruited 237 patients with ischemic stroke or TIA, including 57 cases with prediabetes, 108 with DM, and 72 with normal glucose tolerance. Aspirin and/or clopidogrel resistance was discovered in 28 cases among prediabetes group, which was significantly more frequent than normal glucose tolerance group(49.1% versus 33.3%, P = 0.046). After adjusting for confounding factors, prediabetes was found as an independent risk factor for high on-treatment platelet reactivity (HPR) among patients with recent ischemic stroke or TIA (odds ratio 2.92; 95% CI, 1.29 to 6.63, P = 0.01). Conclusions Prediabetes was an independent risk factor for high on-treatment platelet reactivity in patients with recent ischemic cerebrovascular disease. Patients with prediabetes should be highlighted for the efficacy test of antiplatelet drugs. Keywords Prediabetes . Ischemic stroke . TIA . High on-treatment platelet reactivity (HPR)
Introduction Cerebrovascular disease is the leading cause of death and adult disability in China. Ischemic cerebrovascular disease
* Qian Jia [email protected] 1
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing 100070, China
2
China National Clinical Research Center for Neurological Diseases, Beijing 100070, China
3
Center of Stroke, Beijing Institute for Brain Disorders, Beijing 100070, China
4
Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing 100070, China
5
Department of rehabilitation medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
accounted for about 70% of all. The application of antiplatelet drugs is one of the most important clinical strategies for the prevention and treatment of ischemic cerebrovascular disease.
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