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Model based on single-nucleotide polymorphism to discriminate aspirin resistance patients.
Liu, Qingyuan; Guo, Shuaiwei; Wang, Nuochuan; Wang, Kaiwen; Mo, Shaohua; Li, Xiong; Zhang, Yanan; He, Hongwei; Wang, Shuo; Wu, Jun.
Afiliação
  • Liu Q; Department of Neurosurgery and China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.
  • Guo S; Department of Neurosurgery and China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.
  • Wang N; Department of Blood Transfusion, Beijing Tiantan Hospital, Beijing, China.
  • Wang K; Department of Neurosurgery and China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.
  • Mo S; Department of Neurosurgery and China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.
  • Li X; Department of Neurosurgery, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China.
  • Zhang Y; Department of Blood Transfusion, Beijing Tiantan Hospital, Beijing, China captain9858@126.com zhangyanan@bjtth.org.
  • He H; Department of Neurosurgery and China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Beijing, China.
  • Wang S; Beijing Neurosurgical institution, Capital Medical University, Beijing, China.
  • Wu J; Beijing Neurosurgical institution, Capital Medical University, Beijing, China captain9858@126.com zhangyanan@bjtth.org.
Stroke Vasc Neurol ; 2023 Aug 16.
Article em En | MEDLINE | ID: mdl-37586776
BACKGROUND: Aspirin is widely used for preventing ischaemic events. About 20%-40% of patients have aspirin resistance (ASR), which prevents them from benefiting from aspirin medication. This study aimed to develop and validate a model based on single-nucleotide polymorphism (SNP) to distinguish ASR patients. METHODS: We included patients with spontaneous intracerebral haemorrhage and continuing antiplatelet therapy from a multicentre, prospective cohort study as the derivation cohort. Thromboelastography (inhibition of arachidonic acid channel<50%) was used to identify ASR. Genotyping was performed to identify the ASR-related SNP. Based on the result of the logistic analysis, the aspirin resistance in the Chinese population score (ASR-CN score) was established, and its accuracy was evaluated using the area under the curve (AUC). Patients receiving dual antiplatelet therapy for unruptured intracranial aneurysm embolism were prospectively included in the validation cohort. After embolism, 30-day ischaemic events, including ischaemic stroke, new or more frequent transient ischaemic attack, stent thrombosis and cerebrovascular death, were recorded. RESULTS: The derivation cohort included 212 patients (155 male patients and the median age as 59). 87 (41.0%) individuals were identified with ASR. The multivariate logistic analysis demonstrated six SNPs of GP1BA, TBXA2R, PTGS2 and NOS3 as risk factors related to ASR. The ASR-CN score integrating these SNPs performed well to discriminate ASR patients from non-ASR patients (AUC as 0.77). Based on the validation cohort of 372 patients receiving antiplatelet therapy after embolism (including 130 ASR patients), the ASR-CN score continued to distinguish ASR patients with good accuracy (AUC as 0.80). Patients with high a ASR-CN score were more likely to suffer from 30-day ischaemic events after embolism (OR, 1.28; 95% CI, 1.10 to 1.50; p=0.002). CONCLUSION: GP1BA, TBXA2R, PTGS2 and NOS3 were SNPs related to ASR. The ASR-CN score is an effective tool to discriminate ASR patients, which may guide antiplatelet therapy. CLINICAL TRIAL REGISTRATION: Surgical Treatments of Antiplatelet Intracerebral Hemorrhage cohort (unique identifier: ChiCTR1900024406, http://www.chictr.org.cn/edit.aspx?pid=40640&htm=4).
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Stroke Vasc Neurol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: China País de publicação: Reino Unido

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Idioma: En Revista: Stroke Vasc Neurol Ano de publicação: 2023 Tipo de documento: Article País de afiliação: China País de publicação: Reino Unido