Aspirin resistance in patients with acute coronary events: Risk factors and prevalence as determined by whole blood multiple electrode aggregometry

To determine the prevalence of aspirin resistance and associated risk factors based on biochemical parameters using whole blood multiple electrode aggregometry. The study was conducted at the outpatients cardiology clinic of the Universiti Kebangsaan Malaysia Medical Centre [UKMMC] from August 2011 to February 2012. Subjects on aspirin therapy were divided into two groups; first-ever coronary event and recurrent coronary event. Aspirin resistance was measured by a Multiplate platelet analyser. A total of 74 patients [63 male, 11 female], with a mean age of 57.93 +/- 74.1years were enrolled in the study. The patients were divided into two groups -first-ever coronary event group [n=52] and recurrent coronary event group [n=22]. Aspirin resistance was observed in 12 out of 74 [16%] of the study patients, which consisted of 11 patients from the first-ever coronary event group and one patient from the recurrent coronary event group. There were significant correlations between aspirin resistance and age [r = -0.627; p = 0.029], total cholesterol [r = 0.608; p = 0.036] and LDL [r = 0.694; p = 0.012]. LDL was the main predictor for area under the curve [AUC] for aspirin resistance. However, there was no association between aspirin resistance and cardiovascular events in both groups in this study. Aspirin resistance was observed in 16% of the study population. LDL was the major predictor of aspirin resistance. No association was found in the study between aspirin resistance with recurrent coronary events

Managing Further Rehabilitation in Longer-Term Stroke Patients in the Community: A New Approach

Stroke is becoming a major public health issue in our country due to the fact that there is an increasing life span of our population. Due to advancement of acute management of stroke, three out of four people will survive beyond the acute phase of stroke. Stroke care providers are still debating regarding the exact period of the terminology ‘longer-term stroke’; however many agreed that long-term of stroke refers to the period of one year and thereafter as this period is the determinant for longer-term survival. Management beyond the first year of stroke is complex, encompasses all aspects of patient’s life; physical, psychological and integration into community. Rehabilitation being the cornerstone of longer-term stroke management should now focused on more evidence-based approach as to be effective and relevant to the stroke patients.