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Erschienen in: Translational Stroke Research 5/2018

09.12.2017 | Original Article

Coated-Platelet Trends Predict Short-Term Clinical OutcomeAfter Subarachnoid Hemorrhage

verfasst von: Bappaditya Ray, Vijay M. Pandav, Eleanor A. Mathews, David M. Thompson, Lance Ford, Lori K. Yearout, Bradley N. Bohnstedt, Shuchi Chaudhary, George L. Dale, Calin I. Prodan

Erschienen in: Translational Stroke Research | Ausgabe 5/2018

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Abstract

Aneurysmal subarachnoid hemorrhage (aSAH) is associated with high socio-economic burden. Prothrombotic states of early brain injury (EBI) and delayed cerebral ischemia (DCI) after aSAH determine morbidity and mortality. To understand how activated platelets might contribute to such prothrombotic states, we studied trends in coated-platelets during EBI and DCI periods. Serial blood samples from a prospective cohort of aSAH patients were collected and assayed for coated-platelet levels. Patient’s coated-platelet level during post-hospital discharge follow-up served as an estimate of baseline. Occurrence of DCI, Montreal cognitive assessment (MOCA) score of < 26, and modified Rankin scale (mRS) of 3–6 were considered poor clinical outcomes. Non-linear regression analysis detected a transition between periods of rising and declining coated-platelet levels at day 4. Additional regression analyses of coated-platelet trends before day 4 showed differences among patients with modified Fisher 3–4 [4.2% per day (95% CI 2.4, 6.1) vs. − 0.8% per day (95% CI − 3.4, 1.8); p = 0.0023] and those developing DCI [4.6% per day (95% CI 2.8, 6.5) vs. − 1.9% per day (95% CI − 4.5, 0.5); p < 0.001]. Differences between peak coated-platelet levels and baseline levels were larger, on average for those with DCI [18.1 ± 9.6 vs. 10.6 ± 8.0; p = 0.03], MOCA < 26 [17.0 ± 7.8 vs. 10.7 ± 7.4; p = 0.05] and mRS 3–6 [24.8 ± 10.5 vs. 11.9 ± 7.6; p = 0.01]. Coated-platelet trends after aSAH predict DCI and short-term clinical outcomes. The degree of rise in coated-platelets is also associated with adverse clinical outcomes.
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Metadaten
Titel
Coated-Platelet Trends Predict Short-Term Clinical OutcomeAfter Subarachnoid Hemorrhage
verfasst von
Bappaditya Ray
Vijay M. Pandav
Eleanor A. Mathews
David M. Thompson
Lance Ford
Lori K. Yearout
Bradley N. Bohnstedt
Shuchi Chaudhary
George L. Dale
Calin I. Prodan
Publikationsdatum
09.12.2017
Verlag
Springer US
Erschienen in
Translational Stroke Research / Ausgabe 5/2018
Print ISSN: 1868-4483
Elektronische ISSN: 1868-601X
DOI
https://doi.org/10.1007/s12975-017-0594-7

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