Impact of Enteric Coating on Aspirin Efficacy in Ischemic Stroke Patients: ECASIS Study

The effectiveness of enteric-coated aspirin (EC-ASA) versus plain aspirin (P-ASA) in secondary prevention of ischemic stroke remains uncertain, particularly regarding aspirin responsiveness. In a prospective cohort study of 42 aspirin-naive patients with suspected or newly diagnosed ischemic stroke, no significant difference in aspirin non-responsiveness was observed between EC-ASA and P-ASA groups. However, diabetic patients (HbA1c > 6.5%) showed a higher risk of aspirin non-responsiveness. No gastrointestinal bleeding was reported in either group. These findings suggest that while EC-ASA may be as effective as P-ASA, a notable proportion of patients—especially those with diabetes—may exhibit reduced response to aspirin, warranting further research.