Model based on single-nucleotide polymorphism to discriminate aspirin resistance patients  

作　　者：Qingyuan Liu Shuaiwei Guo Nuochuan Wang Kaiwen Wang Shaohua Mo Xiong Li Yanan Zhang Hongwei He Shuo Wang Jun Wu 

机构地区：[1]Department of Neurosurgery and China National Clinical Research Center for Neurological Diseases,Beijing Tiantan Hospital,Beijing,China [2]Department of Blood Transfusion,Beijing Tiantan Hospital,Beijing,China [3]Department of Neurosurgery,Beijing Chao-Yang Hospital Capital Medical University,Beijing,China [4]Beijing Neurosurgical institution,Capital Medical University,Beijing,China

出　　处：《Stroke & Vascular Neurology》2024年第3期212-220,I0110-I0129,共29页卒中与血管神经病学（英文）

基　　金：supported by the‘National Key Research and Development Program of the 14th Five-Year Plan(Grant No.2021YFC2501100)’;‘Wuxi Taihu Lake Talent Plan,Team in Medical and Health Profession(Grant No.TH202109)’.

摘　　要：Background Aspirin is widely used for preventing ischaemic events.About 20%–40%of patients have aspirin resistance(ASR),which prevents them from benefiting from aspirin medication.This study aimed to develop and validate a model based on single-nucleotide polymorphism(SNP)to distinguish ASR patients.Methods We included patients with spontaneous intracerebral haemorrhage and continuing antiplatelet therapy from a multicentre,prospective cohort study as the derivation cohort.Thromboelastography(inhibition of arachidonic acid channel<50%)was used to identify ASR.Genotyping was performed to identify the ASR-related SNP.Based on the result of the logistic analysis,the aspirin resistance in the Chinese population score(ASR-CN score)was established,and its accuracy was evaluated using the area under the curve(AUC).Patients receiving dual antiplatelet therapy for unruptured intracranial aneurysm embolism were prospectively included in the validation cohort.After embolism,30-day ischaemic events,including ischaemic stroke,new or more frequent transient ischaemic attack,stent thrombosis and cerebrovascular death,were recorded.Results The derivation cohort included 212 patients(155 male patients and the median age as 59).87(41.0%)individuals were identified with ASR.The multivariate logistic analysis demonstrated six SNPs of GP1BA,TBXA2R,PTGS2 and NOS3 as risk factors related to ASR.The ASR-CN score integrating these SNPs performed well to discriminate ASR patients from non-ASR patients(AUC as 0.77).Based on the validation cohort of 372 patients receiving antiplatelet therapy after embolism(including 130 ASR patients),the ASR-CN score continued to distinguish ASR patients with good accuracy(AUC as 0.80).Patients with high a ASR-CN score were more likely to suffer from 30-day ischaemic events after embolism(OR,1.28;95%CI,1.10 to 1.50;p=0.002).Conclusion GP1BA,TBXA2R,PTGS2 and NOS3 were SNPs related to ASR.The ASR-CN score is an effective tool to discriminate ASR patients,which may guide antiplatelet therapy.Clinical trial

关 键 词：PATIENTS ASPIRIN RESISTANCE 

分 类 号：R741[医药卫生—神经病学与精神病学]