The Effect of the ABCB1(MDR-1) C3435T Polymorphism in Turkish Patients with Aspirin Resistance in Acute Ischemic Stroke

• Published in: Translational stroke research Vol. 15; no. 5; pp. 910 - 915
• Main Authors: Yurek, Emrah, Yavuz, Burcu Genc, Tanoglu, Esra Guzel, Gurkas, Erdem, Altundag, Ibrahim, Yalcinkaya, Burhanettin, Yılmaz, Erdal, Colak, Sahin
• Format: Journal Article
• Language: English
• Published: New York Springer US 01-10-2024; Springer Nature B.V
• Subjects: Age; Aged; Anticoagulants; Aspirin; ATP Binding Cassette Transporter, Subfamily B - genetics; Biomedical and Life Sciences; Biomedicine; Blood platelets; Brain Ischemia - epidemiology; Brain Ischemia - genetics; Cardiology; Cardiovascular disease; Chi-square test; Creatinine; Diabetes; Drug Resistance - genetics; Female; Genotype & phenotype; Health sciences; Hemoglobin; Hospitals; Humans; Ischemia; Ischemic Stroke - drug therapy; Ischemic Stroke - epidemiology; Ischemic Stroke - genetics; Leukocytes; Lymphocytes; Male; Middle Aged; Neurology; Neurosciences; Neurosurgery; Neutrophils; Normal distribution; Patients; Platelet Aggregation Inhibitors - therapeutic use; Polymorphism; Polymorphism, Single Nucleotide - genetics; Prospective Studies; Research ethics; Stroke; Turkey - epidemiology; Vascular Surgery; Turkey; Germany; Aspirin resistance; Ischemic stroke; ABCB1 gene C3435T; RT‒PCR; Polymorphism
• ISSN: 1868-4483; 1868-601X; 1868-601X
• DOI: 10.1007/s12975-023-01175-z

Recurrence of thrombotic events during aspirin therapy is known as aspirin resistance (AR). This study aimed to investigate the rate of AR, the factors influencing AR in patients with acute ischemic stroke under regular aspirin use, and the relationship between AR and ABCB1 (MDR-1) C3435T (rs1045642) polymorphism. Throughout this multicenter prospective study, 174 patients with acute ischemic stroke who had been prescribed aspirin for at least one month due to the risk of vascular disease, along with 106 healthy volunteers, were included as part of the study group. The results of our study indicate that AR was detected in 21.3% of the patient group. According to the results of an analysis of the polymorphism of the ABCB1 C3435T in patients with AR compared to those with aspirin sensitivity, patients with AR possessed more heterozygous (CT) and homozygous genotypes (TT) than those with aspirin sensitivity (p = 0.001). Based on multivariate logistic regression analysis of factors affecting AR in acute ischemic stroke patients, hypertension (OR: 5.679; 95% CI: 1.144–28.19; p = 0.034), heterozygous (CT) genotype (OR: 2.557; 95% CI: 1.126–5.807; p = 0.025), increased platelet values (OR: 1.005; 95% CI: 1.001–1.009; p = 0.029), and CRP/albumin values (OR: 1.547; 95% CI: 1.005–2.382; p = 0.047) were found to be associated with a greater risk of AR. The presence of heterozygous (CT) genotype in the ABCB1 C3435T gene region in the Turkish population is associated with an increased risk of AR. When planning aspirin therapy, it is crucial to consider the ABCB1 (MDR-1) C3435T polymorphism.