Aspirin and clopidogrel resistance in Filipino patients with recurrent noncardioembolic ischemic strokes in a tertiary hospital: A cross-sectional study

Diana-lynn Que; Remy Margarette Berroya-moreno; Christian Oliver C Co; Peter Paul Dela Paz Rivera; Vincent Paul E De Guzman; Ma Cristina Macrohon-valdez; Lina C Laxamana; Manuel M Mariano; Maria Carissa C Pineda-franks

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Aspirin and clopidogrel resistance in Filipino patients with recurrent noncardioembolic ischemic strokes in a tertiary hospital: A cross-sectional study

Author: Diana-Lynn Que ¹ ; Remy Margarette Berroya-Moreno ^{1
,

2} ; Christian Oliver C. Co ^{1
,

3
,

4} ; Peter Paul Dela Paz Rivera ^{1
,

5} ; Vincent Paul E. De Guzman ¹ ; Ma. Cristina Macrohon-Valdez ^{1
,

6} ; Lina C. Laxamana ¹ ; Manuel M. Mariano ¹ ; Maria Carissa C. Pineda-Franks ^{1
,

5
,

7}
Author Information

1. St Lukes Medical Center
2. National Kidney Transplant Institute
3. Quirino Memorial Medical Center
4. Rizal Medical Center
5. Philippine General Hospital
6. Taguig Pateros District Hospital
7. Capitol Medical Center
Publication Type:Journal Article
MeSH: Aspirin; Clopidogrel; Ischemic Stroke; Tertiary Care Centers
From: Philippine Journal of Neurology 2024;27(1):20-27
CountryPhilippines
Language:English
Abstract: Background:Antiplatelet resistance is one factor that contributes to stroke recurrence among patients with noncardioembolic ischemic strokes.
Objectives:This paper aims to describe the prevalence of aspirin and clopidogrel resistance, along with frequency of statin, NSAID and proton pump inhibitor use among our cohort of stroke patients. Method. This is a single-center cross-sectional review that included all adult patients with recurrent noncardioembolic ischemic stroke admitted in a tertiary hospital between January 2019 and June 2023.
Results:A total of 1,374 patients were admitted for ischemic stroke from January 2019 to June 2023. Among these, 155 (11.28%) were recurrent noncardioembolic ischemic strokes. Prevalence of aspirin and clopidogrel resistance were 25% and 32.7%, respectively. Clinical profiles of those in the resistant group were comparable with those in the nonresistant group. None of the patients taking aspirin had concomitant use of nonsteroidal antiinflammatory drugs. Only 2 of the patients who were resistant to clopidogrel were on proton pump inhibitors. More than half of the patients both in the resistant and the nonresistant groups were on statin. The study had a small sample size and hence it was not enough to establish causal relationship between factors and antiplatelet resistance.
Conclusion:More patients were resistant to clopidogrel than to aspirin. Further studies with a bigger sample size are recommended to explore factors that contribute to antiplatelet resistance in Filipino patients.
Full text:2024062912080976116pjn 2.pdf