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Effect of prediabetes on asprin or clopidogrel resistance in patients with recent ischemic stroke/TIA

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Abstract

Objective

Diabetes mellitus (DM) had been discovered as an independent risk factor for high on-treatment platelet reactivity (HPR) in patients with ischemic stroke. However, studies on the relationship between prediabetes and the occurrence of HPR remain scarce. This study is aimed at clarifying the association between prediabetes and HPR among patients with recent ischemic stroke or transient ischemic stroke (TIA).

Methods

Patients with ischemic stroke or TIA within 90 days after onset were recruited consecutively. All patients were divided into three groups: DM, prediabetes, and normal glucose tolerance according to fasting glucose, HbA1c, or OGTT. Three months later, all patients were performed platelet aggregation inhibition test and screened for high on-treatment platelet reactivity. The effect of prediabetes on HPR was analyzed in a multivariable logistic regression model.

Results

This study recruited 237 patients with ischemic stroke or TIA, including 57 cases with prediabetes, 108 with DM, and 72 with normal glucose tolerance. Aspirin and/or clopidogrel resistance was discovered in 28 cases among prediabetes group, which was significantly more frequent than normal glucose tolerance group(49.1% versus 33.3%, P = 0.046). After adjusting for confounding factors, prediabetes was found as an independent risk factor for high on-treatment platelet reactivity (HPR) among patients with recent ischemic stroke or TIA (odds ratio 2.92; 95% CI, 1.29 to 6.63, P = 0.01).

Conclusions

Prediabetes was an independent risk factor for high on-treatment platelet reactivity in patients with recent ischemic cerebrovascular disease. Patients with prediabetes should be highlighted for the efficacy test of antiplatelet drugs.

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Data availability

The protocol and the statistical analysis plans are available on reasonable request. Deidentified participant data are not available for legal and ethical reasons.

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Funding

This study was funded by National Key Research and Development Program of the Ministry of Science and Technology of The People’s Republic of China (2018YFC1312303, 2016YFC1301604, 2018YFC1705003, 2018YFC2002302).

Author information

Authors and Affiliations

  1. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 119 S 4th Ring W Rd, Fengtai District, Beijing, 100070, China

    Weili Jia, Qian Jia, Yumei Zhang, Xingquan Zhao & Yongjun Wang

  2. China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China

    Weili Jia, Qian Jia, Yumei Zhang, Xingquan Zhao & Yongjun Wang

  3. Center of Stroke, Beijing Institute for Brain Disorders, Beijing, 100070, China

    Weili Jia, Qian Jia, Yumei Zhang, Xingquan Zhao & Yongjun Wang

  4. Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, 100070, China

    Weili Jia, Qian Jia, Yumei Zhang, Xingquan Zhao & Yongjun Wang

  5. Department of rehabilitation medicine, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China

    Yumei Zhang

Authors
  1. Weili Jia
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  2. Qian Jia
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  3. Yumei Zhang
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Weili Jia and Qian Jia. The first draft of the manuscript was written by Weili Jia, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Qian Jia.

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Conflict of interest

The authors declare that they have no conflicts of interest pertaining to this paper.

Ethics approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of the Ethics Committee at Beijing Tiantan Hospital approved this study.

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Jia, W., Jia, Q., Zhang, Y. et al. Effect of prediabetes on asprin or clopidogrel resistance in patients with recent ischemic stroke/TIA. Neurol Sci 42, 2829–2835 (2021). https://doi.org/10.1007/s10072-020-04881-w

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  • DOI: https://doi.org/10.1007/s10072-020-04881-w

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