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

objectivesTo investigate the association of aspirin resistance (AR) with the plasma 4-hydroxynonenal (4-HNE) level and its impact on recurrent cerebral infarction (CI) in patients with acute cerebral infarction (ACI) who were receiving aspirin therapy.

methodsOne hundred and fifty-four ACI patients who previously received aspirin therapy (100 mg/day) were enrolled. Whole urine (for measuring 11dhTXB2 and creatinine) along with blood (for measuring the plasma 4-HNE level) were collected at least 7 days after the patients received aspirin. A cutoff of 1500 pg/mg of 11dhTXB2/ creatinine was used to determine AR. A follow-up period to monitor recurrence CI events was 1 year. In addition, blood testing was performed when the patients were first admitted to hospital.

resultsForty-six of the 154 enrolled patients (29.9%) were found to be AR. No statistical difference in age, sex, hypertension, diabetes mellitus, coronary disease, smoking status, NIHSS score, TOAST classification, platelet count, thrombocytocrit, LDL-C, HDL-C, TG, and TC was found between the AR and aspirin-sensitive (AS) patients, but the plasma 4-HNE level was found to be higher in the AR patients than AS patients (p < .05). Multiple logistic regression analysis showed that the 4-HNE level was associated with a higher risk of AR (OR = 1.034; 95% CI = 1.011-1.058; p < .05). Moreover, 1-year follow-up showed that AR was more prevalent in patients with recurrent CI (26 (56.6%)) than those without (20/(43.5%)) (p < .001).

conclusionsThe plasma 4-HNE level is strongly associated with AR and thus may be a factor contributing to AR. Patients with AR have a greater risk of recurrence CI.