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Research ArticleNeurointervention

Prevalence and Risk Factors for Aspirin and Clopidogrel Resistance in Cerebrovascular Stenting

S. Prabhakaran, K.R Wells, V.H. Lee, C.A. Flaherty and D.K. Lopes
American Journal of Neuroradiology February 2008, 29 (2) 281-285; DOI: https://doi.org/10.3174/ajnr.A0818
S. Prabhakaran
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K.R Wells
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V.H. Lee
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C.A. Flaherty
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D.K. Lopes
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    Fig 1.

    A, Scatterplot of aspirin reaction units (x-axis) versus aspirin dose (y-axis). There is a strong inverse correlation (P = .01). Gray area indicates aspirin resistance. B, Scatterplot of platelet inhibition (x-axis) versus clopidogrel dose (y-axis). There is no correlation (P = .64). Gray area indicates clopidogrel resistance.

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    Table 1:

    Univariable ANOVA of clinical variables as predictors of platelet inhibition

    Platelet Inhibition (%)Parameter Estimate (b)P Value
    Demographics
        Age (years)–−0.25.303
        Age groups (No.)−15.8.031
            <55 years (21)53.0
            >55 years (34)37.2
        Sex (No.)−2.3.755
            Women (34)44.1
            Men (21)41.8
    Medical history
        Hypertension (No.)−13.1.077
            No (34)48.2
            Yes (21)35.1
        Diabetes (No.)−24.0.036
            No (49)45.8
            Yes (6)21.8
        Hypercholesterolemia (No.)−11.8.153
            No (41)46.2
            Yes (14)34.4
        Coronary artery disease (No.)2.7.789
            No (47)43.6
            Yes (8)40.9
        Prior stroke (No.)6.7.414
            No (40)41.4
            Yes (15)48.1
        Prior TIA (No.)−11.6.288
            No (48)44.7
            Yes (7)33.1
        Statin use (No.)−13.9.085
            No (40)47.0
            Yes (15)33.1
        ACE-I use (No.)−13.5.199
            No (48)45.0
            Yes (7)31.5
        Beta blocker use (No.)−4.0.684
            No (46)43.9
            Yes (9)39.9
        Ca-channel blocker use (No.)6.9.671
            No (52)42.8
            Yes (3)49.7
        Diuretic use (No.)−5.1.471
            No (49)44.1
            Yes (6)35.7
        Aspirin use (No.)−8.4.562
            No (3)52.0
            Yes (52)47.7
        Timing of clopidogrel initiation (No.)−0.8.889
            <3 days (14)43.2
            3–7 days (25)44.9
            >7 days (16)40.7
    Laboratory values
        Creatinine (mg/dL)–−22.7.175
        Glucose (mg/dL)–−0.21.035
        Hemoglobin (g/dL)–−0.55.825
        Platelet count (1,000/μL)–0.07.190
    Angiographic features
        Stent indication (No.)−6.0.490
            Aneurysm (42)45.1
            Stenosis (13)39.1
        Stent location (No.)−14.7.029
            MCA/ACA/PcomA (19)53.4
            Other (36)38.7
    Outcomes
        Re-stenosis at 6 months (No.)7.8.774
            No (54)43.1
            Yes (1)50.9
        Stroke or TIA at 6 months (No.)−4.8.806
            No (53)43.4
            Yes (2)38.6
    • Note:— –indicates data not available; TIA, transient ischemic attack; Ca, calcium; MCA, middle cerebral artery; ACA, anterior cerebral artery; PcomA, posterior communicating artery; No., number.

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    Table 2:

    Multivariable linear regression model for dependent variable (percentage platelet inhibition) with the following dependent variables: indication for stenting (wide-neck aneurysm vs stenosis), location of stent (anterior circulation vs other), age >55 years, diabetes, hypertension, hypercholesterolemia, statin use, ACE-I use, and baseline glucose, creatinine, and platelet levels (n = 55)

    Unstandardized CoefficientsStandardized CoefficientsP Value95% CI for b
    bStd. ErrorbtLower BoundUpper Bound
    (Constant)56.845.5510.249.00045.70867.964
    Diabetes mellitus−26.8310.61−0.319−2.529.015−48.128−5.540
    Age <55 years−16.336.81−0.303−2.399.020−30.001−2.673
    • Note:—CI indicates confidence interval; Std. Error, standard error.

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American Journal of Neuroradiology: 29 (2)
American Journal of Neuroradiology
Vol. 29, Issue 2
February 2008
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S. Prabhakaran, K.R Wells, V.H. Lee, C.A. Flaherty, D.K. Lopes
Prevalence and Risk Factors for Aspirin and Clopidogrel Resistance in Cerebrovascular Stenting
American Journal of Neuroradiology Feb 2008, 29 (2) 281-285; DOI: 10.3174/ajnr.A0818

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Prevalence and Risk Factors for Aspirin and Clopidogrel Resistance in Cerebrovascular Stenting
S. Prabhakaran, K.R Wells, V.H. Lee, C.A. Flaherty, D.K. Lopes
American Journal of Neuroradiology Feb 2008, 29 (2) 281-285; DOI: 10.3174/ajnr.A0818
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