Impact of clopidogrel resistance on stroke severity in patients with acute ischemic stroke
DOI:
https://doi.org/10.54029/2025ffeKeywords:
stroke, platelet function test, clopidogrel resistance, outcomeAbstract
Background: Prior use of antiplatelet agents is associated with reduced severity in patients with ischemic stroke. However, clopidogrel resistance, which is characterized by a suboptimal platelet response to clopidogrel, diminishes the drug’s efficacy. This study aimed to investigate the impact of clopidogrel resistance on stroke severity in patients receiving clopidogrel.
Methods: A total of 116 patients who developed acute ischemic stroke while on clopidogrel, presented to two hospitals within 72 h of symptom onset, and underwent clopidogrel resistance testing using the VerifyNow assay were enrolled. The relationship between the VerifyNow parameters and stroke severity was analyzed using correlation and multivariable regression analyses.
Results: Among the VerifyNow parameters, percent inhibition showed a significant inverse correlation with National Institutes of Health Stroke Scale (NIHSS) score at admission (r = -0.387, p < 0.001), whereas the P2Y12 reaction unit (PRU) exhibited a significant positive correlation (r = 0.207, p = 0.028). Multivariable analysis confirmed a significant inverse relationship between percent inhibition and NIHSS score at admission (B = -0.107, 95% confidence interval = -0.163 to -0.051; p < 0.001). However, PRU was not significantly associated with NIHSS score at admission in the multivariable analysis.
Conclusions: Clopidogrel resistance, particularly lower percent inhibition, was associated with greater stroke severity in patients receiving clopidogrel.
