Aspirin nonresponse in patients with arterial causes of ischemic stroke: Considerations in detection and management

Can the Previous Therapeutic Control of the Main Risk Factors of Cerebrovascular Disease Influence the Acetylsalicylic Acid–Nonresponsive Status in Acute Ischemic Stroke Patients? Results from a Portuguese Prospective Cohort Study

“…A link to ASA resistance and clinical conditions has been well demonstrated in cardiovascular disorders such as coronary artery disease, heart failure, cerebrovascular disease, diabetes, obesity, metabolic syndrome, and hyperlipidemia. [18][19][20][21][22][23][24][25][26][27][28] Several lines of evidence demonstrate that ASA resistance is a dynamic phenomenon that can develop during the course of treatment although not initially present, 21,22 and its onset can occur under the influence of conditions that are associated with higher platelet activation, such as inflammation. 18,23 Our results indicate a possible influence of antihypertensive drug treatment on a decreased risk of occurrence of ASA-nonresponsive status in patients.…”

“…The benefit of reducing blood pressure for primary and secondary prevention of stroke has been established. 25 Blood pressure-induced endothelial and platelet activation in hypertension is a well-recognized association. The prognostic value and the correlation of these events with the severity of hypertension or organ damage are not well established or understood.…”

Antiplatelet therapy in ischemic stroke: Variability in clinical trials and its impact on choosing the appropriate therapy

“…Decreased platelet responsiveness to aspirin has also been observed in some patients following treatment for an ischemic stroke or TIA. The basis of the resistance could be contributed to by the drug's pharmacodynamic profile, as well as the variation in assays employed to determine coagulation, and was the topic of a recent review [77]. Studies are ongoing to better understand the clinical impact of antiplatelet resistance, especially with respect to the effect on outcomes.…”