Clopidogrel-Related High Residual Platelet Reactivity Associated with Estimated Glomerular Filtration Rate in Patients with Acute Ischemic Stroke

Introduction: There are few studies on the relationship between the occurrence of clopidogrel-related high residual platelet reactivity (HRPR) and estimated glomerular filtration rate (eGFR) at admission in patients with ischemic stroke. The aim of this study was to investigate the possible relationship between the two. Methods: Patients who were hospitalized and diagnosed with acute ischemic stroke were recruited from 1 July 2017 to 30 June 2018 at Shanghai TCM-Integrated Hospital. Renal function was measured within 24 h of enrolment and eGFR was calculated. Patients were tested for platelet reactivity using the VerifyNow System after 7 days of antiplatelet therapy with clopidogrel 75 mg/d alone, and patients with P2Y12 reaction unit values >= 230 were diagnosed as HRPR. The association between HRPR and eGFR was analyzed.Results: A total of 274 patients were enrolled in the study, of whom 91 (33.21%) had HRPR. Multivariate logistic regression analysis suggested that an increased risk of HRPR was independently associated with female sex and reduced eGFR (female sex: OR=2.24, 95% CI: 1.26-3.99, P=0.006; mild CKD: R=2.95, 95% CI: 1.47-5.93, P=0.002; moderate CKD: OR=3.07, 95% CI: 1.08-8.75, P=0.04). Conclusion: Decreased eGFR is an independent risk factor for the occurrence of HRPR in patients with ischemic stroke.