Abstract|Stroke 1| Volume 357, SUPPLEMENT 1, e101, October 15, 2015

PIAST — Platelet inhibition assessment in stroke trial multiplate analyzer based assessment of the efficacy of antithrombotic medication in stroke patients

      Objective: The aim of this prospective trial was to assess 1) the percentage of patients being treated with antiplatelet medications (AM) prior to or for secondary prevention of stroke who disclose an insufficient platelet aggregation (PA) inhibition assessed with Multiplate (MEA) — a validated platelet function test — and 2) conditions that might contribute to PA.
      Background: A significant number of patients suffer from a recurrent cerebral ischemia despite treatment with AM without detectable progression of the underlying illness likely due to antiplatelet non-responsiveness caused by different factors. Platelet function was analyzed through MEA to identify the effects of antiplatelet therapy in stroke patients. Furthermore, the question if aspirin related insufficient platelet inhibition is correlated with the clinical diagnosis is addressed.
      Methods: We analyzed the platelet function of 455 patients admitted with a suspected stroke either prior to being treated with aspirin and clopidogrel or being newly placed on AM employing MEA.
      Results: Data shows that 120 (26.3%) of all examined patients with suspected ischemic stroke fall into the category of potential resistance to antiplatelet agents, mounting to 30% of the eventually confirmed 400 cerebral ischemia patients. Increased inflammatory biomarkers and use of NSAIDs was associated with an elevated PA and stroke/TIA incidence. Diabetes mellitus and decreased renal function do not seem to have an impact though. Insufficient PA seems to correlate with an increased rate of cerebral ischemia.
      Conclusion: Nearly 1/3 of cerebral ischemia patients are potential aspirin nonresponders, which might have significant implications in the medical treatment of stroke patients.
      I have obtained patient and/or Institutional Review Board (IRB) approval, as necessary