Poster Presentation Asia Pacific Stroke Conference 2024

Aspirin and Clopidogrel resistance in Filipino patients with recurrent noncardioembolic ischemic strokes in a tertiary hospital (#427)

DIANA-LYNN QUE 1 , Remy Margarette Berroya-Moreno 1 , Christian Oliver Co 1 , Peter Paul Rivera 1 , Vincent Paul De Guzman 1 , Ma. Cristina Macrohon-Valdez 1 , Lina Laxamana 1 , Manuel Mariano 1 , Maria Carissa Pineda-Franks 1
  1. Stroke Service, Institute for Neurosciences, St. Luke's Medical Center, Taguig, Philippines

Background. Antiplatelet resistance is one factor that contributes to stroke recurrence among patients with noncardioembolic ischemic strokes. Various methods are available in determining the response to aspirin and clopidogrel, one is the Rosche Multiplate Analyzer which correlates well with the gold standard light transmission aggregometry (LTA). Objectives. This paper aims to describe aspirin and clopidogrel resistance among Filipino patients with recurrent noncardioembolic ischemic strokes in a tertiary hospital. 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.