Objective To investigate the relationship between aspirin resistance and Lp-PLA2 and recurrent ischemic stroke in non-cardioembolic stroke patients.Methods Seventy-two patients with acute non-cardiogenic ischemic stroke within 7 days of onset hospitalized in the People's Hospital of Yongcheng from October 2021 to October 2022 were selected.Based on clinical history and neuroimaging evidence,the patients were divided into primary group(n=36)and recurrent group(n=36).After admission,the patients were regularly treated with aspirin for 7 days.Aspirin resistance was measured by thrombologram.Serum Lp-PLA2 levels were determined.Logistic regression analysis was used to screen out independent risk factor for recurrent ischemic stroke.The predictive value of risk factors was mearured by the area under the ROC curve.Results Aspirin resistance was found in 36.1％of patients with recurrent stroke,while in 19.4％of patients with initial stroke,with a statistically significant difference between the two groups(P＜0.001).The median of serum Lp-PLA2 level in patients with recurrent stroke was 160.0 μ.g/L,which was 125.0 µg/L in patients with initial stroke,with a statistically significant difference between the two groups(P=0.008).Logistic regression analysis showed that aspirin resistance and high PLA2 levels were factors for recurrent ischemic stroke.Patients with aspirin resistance had a 4.06-fold increased risk of recurrent stroke(P=0.042),patients with higher Lp-PLA2 median value had a 4.37-fold increased risk of recurrent stroke(P=0.011).The area under the ROC curve for aspirin resistance and Lp-PLA2 in predicting recurrent stroke was 0.753 and 0.683,respectively,with 95％confidence intervals(0.641-0.873 and 0.559-0.807,respectively).Conclusion The ratio of aspirin resistance and serum Lp-PLA2 level in recurrent stroke patients are significantly higher than those in primary stroke patients,which can be used as risk predictors of stroke recurrence.
维普
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