Response to Letter Regarding Article “Clinical Outcomes Using a Platelet Function-Guided Approach for Secondary Prevention in Patients With Ischemic Stroke or Transient Ischemic Attack”

Abstract

We thank Drs Meves and Neubauer for their interest in our recent article, “Clinical Outcomes Using a Platelet Function-Guided Approach for Secondary Prevention in Patients With Ischemic Stroke or Transient Ischemic Attack.”1 Regarding the definition for aspirin nonresponse in our study, we had used the available clinical test at our institution during the time period of the study. Aspirin resistance was defined as meeting 2 criteria for mean platelet aggregation based on testing with arachidonic acid and adenosine diphosphate; patients who met only one of the 2 criteria were defined as incomplete responders.1 The modifications in antiplatelet management did not differ between patients labeled as aspirin-resistant or incomplete responders; thus, we chose to combine both to comprise our aspirin nonresponse cohort. Nonadherence to antiplatelet therapy is indeed a major issue in interpreting platelet function studies. In fact, nonadherence is likely …