Association of aspirin resistance with 4‐hydroxynonenal and its impact on recurrent cerebral infarction in patients with acute cerebral infarction

Guo, Jian; Wang, Jue; Guo, Yanxia; Feng, Juan

doi:10.1002/brb3.1562

Cited by 4 publications

(6 citation statements)

References 39 publications

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“…Next, the remaining 113 articles went through full‐text review, and 83 of them were removed due to predefined inclusion and exclusion criteria. Eventually, 30 articles were included and went through meta‐analysis 19–48 . The study selection process was shown in Figure 1.…”

Section: Resultsmentioning

confidence: 99%

High on‐treatment platelet reactivity is associated with poor outcomes after ischemic stroke: A meta‐analysis

Zhou

et al. 2022

Acta Neuro Scandinavica

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Objectives High on‐treatment platelet reactivity (HTPR) determined by platelet function assays is present in certain patients with ischemic stroke or transient ischemic attack (TIA). However, it is unclear whether HTPR is associated with poor clinical outcomes. Our study aimed to investigate the relationship of HTPR with recurrent vascular events in ischemic stroke or TIA. Methods Pubmed (MEDLINE), EMBASE, and Cochrane Library were searched for eligible studies from inception to January 1, 2022. Stata 17.0 software was used to calculate the risk ratio (RR). Subgroup and sensitivity analyses were conducted to assess the source of heterogeneity. A random‐effects model was used when heterogeneity was present. Primary endpoint of the meta‐analysis was the risk ratio of recurrent vascular events in HTPR Patients. While stroke and TIA, all‐cause death, early neurological deterioration, early new ischemic lesions, and stroke severity measured by National Institute of Health Stroke Scale (NIHSS) scores at admission were also pooled. Results Thirty articles (7995 patients) were eligible including 28 cohort studies and 2 prospective case–control studies. The prevalence of HTPR varied from 5.9% to 60%. HTPR was associated with an increased risk of recurrent vascular events (RR = 2.94, 95% CI 2.04–4.23), stroke recurrence (RR = 2.05; 95% CI 1.43–2.95), and all‐cause mortality (RR = 2.43; 95% CI 1.83–3.22). Subgroup analysis showed that HTPR determined by optical aggregometry, Verify‐Now system and 11dh TXB2 is related to a higher risk of recurrent vascular events (RR = 3.53, 95% CI 1.51–9.40; RR = 2.16, 95% CI 1.02–4.56; RR = 3.76, 95% CI 1.51–9.40, respectively). Moreover, patients with HTPR had an increased incidence of early neurological deterioration (RR = 2.75; 95% CI 1.76–4.30) and higher NIHSS scores at admission (Mean difference 0.19, 95% CI 0.01–0.36). Conclusions This meta‐analysis demonstrates HTPR is associated with higher risk of recurrent vascular events, early neurological deterioration and increased severity in patients with ischemic stroke and TIA. HTPR measured by platelet function assays may guide the use of antiplatelet agents in ischemic stroke and TIA.

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Section: Resultsmentioning

confidence: 99%

High on‐treatment platelet reactivity is associated with poor outcomes after ischemic stroke: A meta‐analysis

Zhou

et al. 2022

Acta Neuro Scandinavica

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“…4-HNE is an aldehyde substance closely related to oxidative stress and lipid peroxidation, and oxidative stress is one of the main factors causing ischemic injury, suggesting that the increase of serum 4-HNE might be one of the main mechanisms underlying the increased risk of stroke induced by oxidative stress ( Poli and Schaur, 2000 ; Liu et al, 2020 ). Importantly, a previous study found that serum 4-HNE level was significantly higher in patients with aspirin-resistant cerebral infarction than in patients with aspirin-sensitive cerebral infarction, and the recurrence rate of aspirin-resistant cerebral infarction patients was significantly higher than that of aspirin-sensitive patients with cerebral infarction, indirectly suggesting that serum 4-HNE may be associated with the recurrence of cerebral infarction ( Guo et al, 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…4-Hydroxynonenal (4-HNE) is the most representative substance among the aldehyde products of lipid peroxidation, mainly produced by linoleic acid and arachidonic acid, etc., in lipid peroxidation ( Castro et al, 2017 ; Gallo et al, 2020 ). Importantly, Guo et al (2020) found that 4-HNE was closely related to aspirin sensitivity in patients with acute cerebral infarction, with higher levels associated with a greater risk of aspirin resistance in patients. Moreover, aspirin resistance is considered to be a risk factor for the recurrence of cerebral infarction ( Yi et al, 2013 ; Wiśniewski et al, 2020 ), so 4-HNE may also be associated with the recurrence of cerebral infarction, but there is a lack of direct research evidence.…”

Section: Introductionmentioning

confidence: 97%

Serum 4-hydroxynonenal associates with the recurrence of patients with primary cerebral infarction

Liu

Mei-ling²,

Fan³

et al. 2022

Front. Cell. Neurosci.

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Background4-Hydroxynonenal (4-HNE), an α, β-unsaturated hydroxyalkenal, has been found to be associated with aspirin resistance, which is a risk factor for recurrent cerebral infarction. However, its effect on recurrent cerebral infarction is less defined. We designed this study to investigate the association between 4-HNE and increased risk of recurrent cerebral infarction.MethodsWe recruited 189 patients with primary cerebral infarction from 2017 to 2019. According to the recurrence of cerebral infarction during the 3-year follow-up period, they were divided into two groups, namely, the non-recurrence group (n = 93) and the recurrence group (n = 96). All patients were analyzed to explore the risk factors for the recurrence of primary cerebral infarction and the predictive value of serum 4-HNE for the recurrence of cerebral infarction.ResultsThe levels of serum 4-HNE in patients of the recurrence group were significantly higher than that in patients of the non-recurrence group. There was a positive correlation between serum 4-HNE levels and the serum levels of triglyceride (r = 0.448, p = 0.008) and low-density lipoprotein cholesterol (LDL-C; r = 0.442, p = 0.002) in primary cerebral infarction patients. Cox proportional hazards modeling showed that demographic and certain clinical parameters, such as age, serum triglyceride levels, the National Institutes of Health Stroke Scale (NIHSS) scores, and serum 4-HNE levels, were independent factors for the recurrence in patients. The results of the receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) value of serum 4-HNE in patients with cerebral infarction recurrence was 0.703, and when the cutoff value of serum 4-HNE was set at 42.34 ng/ml, the sensitivity and specificity values of serum 4-HNE in predicting recurrent cerebral infarction were 79.20 and 52.70%, respectively.ConclusionSerum 4-HNE is an independent risk factor for the recurrence of patients with primary cerebral infarction, and it may become a new intervention way to prevent the recurrence of patients with cerebral infarction.

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“…Homocysteine is thought to influence platelet activity by increasing oxidative stress and causing endothelium dysfunction, which results in reduced nitric oxide (NO) synthesis and bioavailability [ 27 ]. The importance of oxidative stress for platelet activity has been indirectly shown, as its final product, 4-hydroxynonenal (4-HNE), is a predictor of aspirin resistance in patients with acute cerebral infarction [ 28 ]. Homocysteine is also a predictor of 11-dehydro-TXB2 levels in patients with arterial hypertension [ 29 ], which had a high prevalence in our group (93%).…”

Section: Discussionmentioning

confidence: 99%

Urine 11-Dehydro-Thromboxane B2 in Aspirin-Naive Males with Metabolic Syndrome

Piechota

Krzesiński

Piotrowicz

et al. 2022

JCM

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Urine 11-dehydro-thromboxane B2 (11-dehydro-TXB2), an indirect measure of platelet activity, is elevated in cardiovascular diseases and diabetes. The purpose of our study was to determine whether urine 11-dehydro-TXB2 is elevated in aspirin-naive males with metabolic syndrome (MS) and to determine predictors of 11-dehydro-TXB2 levels. The secondary aim was to evaluate whether these MS patients could be potential candidates for the aspirin-mediated prevention of atherosclerotic cardiovascular diseases (ASCVDs). In 82 males with MS (76 hypertensive), anthropometric measures, urine 11-dehydro-TXB2, platelet count, creatinine, glucose, insulin, estimated insulin resistance, lipid parameters, high-sensitivity C-reactive protein (hs-CRP), adiponectin, homocysteine, and ten-year risk of fatal cardiovascular disease (SCORE) were assessed. Urine 11-dehydro-TXB2 levels were elevated (≥2500 pg/mg creatinine) in two-thirds of patients, including 11 high-risk patients (SCORE ≥ 5%). Homocysteine, adiponectin, hs-CRP, waist-to-hip ratio, and total cholesterol were found to be predictors of urine 11-dehydro-TXB2. In conclusion, there is a high incidence of elevated urine 11-dehydro-TXB2 in males with MS, including in some patients who are at a high or very high risk of ASCVDs. 11-dehydro-TXB2 levels are associated with hyperhomocysteinemia, inflammation, fat distribution, hypercholesterolemia, and adiponectin concentrations. Elevated 11-dehydro-TXB2 levels may support the use of personalised aspirin ASCVD prevention in high-risk males with MS. Giuseppe Patti.

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Association of aspirin resistance with 4‐hydroxynonenal and its impact on recurrent cerebral infarction in patients with acute cerebral infarction

Cited by 4 publications

References 39 publications

High on‐treatment platelet reactivity is associated with poor outcomes after ischemic stroke: A meta‐analysis

High on‐treatment platelet reactivity is associated with poor outcomes after ischemic stroke: A meta‐analysis

Serum 4-hydroxynonenal associates with the recurrence of patients with primary cerebral infarction

Urine 11-Dehydro-Thromboxane B2 in Aspirin-Naive Males with Metabolic Syndrome

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