Reduced platelet activity is associated with early clot growth and worse 3-month outcome after intracerebral hemorrhage

Andrew M. Naidech, Borko Jovanovic, Storm Liebling, Rajeev K. Garg, Sarice L. Bassin, Bernard Bendok, Richard A. Bernstein, Mark J. Alberts, H. Hunt Batjer

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

Background and Purpose-Antiplatelet medication use and reduced platelet activity may be associated with mortality after intracerebral hemorrhage (ICH). We tested the hypothesis that reduced platelet activity is associated with early ICH clot growth and worse outcomes. Methods-We prospectively identified patients with spontaneous ICH, measured platelet activity (VerifyNow-ASA, Accumetrics) on admission, and recorded antiplatelet medication use. ICH volume was calculated using computerized volumetric analysis. Data were analyzed with nonparametric statistics and repeated measures ANOVA as appropriate. Patients were prospectively followed for functional outcomes. Data are presented as mean±SD or median [Q1 to Q3]. Results-Reduced platelet activity (≤550 aspirin reaction units [ARU]) was associated with increased ICH volume growth (P<0.05) for patients with the diagnostic CT within 12 hours. In the subset of patients not known to take aspirin, 24% had reduced platelet activity. Sixteen (24%) patients received a platelet transfusion 21.2±11.4 hours after symptom onset with an increase in platelet activity (448 [414-479] to 586 [530-639] ARU, P=0.001), but without impact on outcomes. Reduced platelet activity was associated with worse modified Rankin Scores at 3 months (P=0.02). Conclusions-Reduced platelet activity was associated with early ICH volume growth and worse functional outcome. Because platelet activity can be increased with platelet transfusion, increasing platelet activity is a potential method to reduce ICH volume growth and improve functional outcomes.

Original languageEnglish (US)
Pages (from-to)2398-2401
Number of pages4
JournalStroke
Volume40
Issue number7
DOIs
StatePublished - Jul 1 2009
Externally publishedYes

Fingerprint

Cerebral Hemorrhage
Blood Platelets
Growth
Aspirin
Platelet Transfusion
Nonparametric Statistics
Analysis of Variance
Mortality

Keywords

  • ICH
  • Intracranial hemorrhage
  • Neurocritical care
  • Platelets

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Clinical Neurology
  • Advanced and Specialized Nursing

Cite this

Naidech, A. M., Jovanovic, B., Liebling, S., Garg, R. K., Bassin, S. L., Bendok, B., ... Batjer, H. H. (2009). Reduced platelet activity is associated with early clot growth and worse 3-month outcome after intracerebral hemorrhage. Stroke, 40(7), 2398-2401. https://doi.org/10.1161/STROKEAHA.109.550939

Reduced platelet activity is associated with early clot growth and worse 3-month outcome after intracerebral hemorrhage. / Naidech, Andrew M.; Jovanovic, Borko; Liebling, Storm; Garg, Rajeev K.; Bassin, Sarice L.; Bendok, Bernard; Bernstein, Richard A.; Alberts, Mark J.; Batjer, H. Hunt.

In: Stroke, Vol. 40, No. 7, 01.07.2009, p. 2398-2401.

Research output: Contribution to journalArticle

Naidech, AM, Jovanovic, B, Liebling, S, Garg, RK, Bassin, SL, Bendok, B, Bernstein, RA, Alberts, MJ & Batjer, HH 2009, 'Reduced platelet activity is associated with early clot growth and worse 3-month outcome after intracerebral hemorrhage', Stroke, vol. 40, no. 7, pp. 2398-2401. https://doi.org/10.1161/STROKEAHA.109.550939
Naidech, Andrew M. ; Jovanovic, Borko ; Liebling, Storm ; Garg, Rajeev K. ; Bassin, Sarice L. ; Bendok, Bernard ; Bernstein, Richard A. ; Alberts, Mark J. ; Batjer, H. Hunt. / Reduced platelet activity is associated with early clot growth and worse 3-month outcome after intracerebral hemorrhage. In: Stroke. 2009 ; Vol. 40, No. 7. pp. 2398-2401.
@article{04a179afced24fc19ce944de95b4adb7,
title = "Reduced platelet activity is associated with early clot growth and worse 3-month outcome after intracerebral hemorrhage",
abstract = "Background and Purpose-Antiplatelet medication use and reduced platelet activity may be associated with mortality after intracerebral hemorrhage (ICH). We tested the hypothesis that reduced platelet activity is associated with early ICH clot growth and worse outcomes. Methods-We prospectively identified patients with spontaneous ICH, measured platelet activity (VerifyNow-ASA, Accumetrics) on admission, and recorded antiplatelet medication use. ICH volume was calculated using computerized volumetric analysis. Data were analyzed with nonparametric statistics and repeated measures ANOVA as appropriate. Patients were prospectively followed for functional outcomes. Data are presented as mean±SD or median [Q1 to Q3]. Results-Reduced platelet activity (≤550 aspirin reaction units [ARU]) was associated with increased ICH volume growth (P<0.05) for patients with the diagnostic CT within 12 hours. In the subset of patients not known to take aspirin, 24{\%} had reduced platelet activity. Sixteen (24{\%}) patients received a platelet transfusion 21.2±11.4 hours after symptom onset with an increase in platelet activity (448 [414-479] to 586 [530-639] ARU, P=0.001), but without impact on outcomes. Reduced platelet activity was associated with worse modified Rankin Scores at 3 months (P=0.02). Conclusions-Reduced platelet activity was associated with early ICH volume growth and worse functional outcome. Because platelet activity can be increased with platelet transfusion, increasing platelet activity is a potential method to reduce ICH volume growth and improve functional outcomes.",
keywords = "ICH, Intracranial hemorrhage, Neurocritical care, Platelets",
author = "Naidech, {Andrew M.} and Borko Jovanovic and Storm Liebling and Garg, {Rajeev K.} and Bassin, {Sarice L.} and Bernard Bendok and Bernstein, {Richard A.} and Alberts, {Mark J.} and Batjer, {H. Hunt}",
year = "2009",
month = "7",
day = "1",
doi = "10.1161/STROKEAHA.109.550939",
language = "English (US)",
volume = "40",
pages = "2398--2401",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "7",

}

TY - JOUR

T1 - Reduced platelet activity is associated with early clot growth and worse 3-month outcome after intracerebral hemorrhage

AU - Naidech, Andrew M.

AU - Jovanovic, Borko

AU - Liebling, Storm

AU - Garg, Rajeev K.

AU - Bassin, Sarice L.

AU - Bendok, Bernard

AU - Bernstein, Richard A.

AU - Alberts, Mark J.

AU - Batjer, H. Hunt

PY - 2009/7/1

Y1 - 2009/7/1

N2 - Background and Purpose-Antiplatelet medication use and reduced platelet activity may be associated with mortality after intracerebral hemorrhage (ICH). We tested the hypothesis that reduced platelet activity is associated with early ICH clot growth and worse outcomes. Methods-We prospectively identified patients with spontaneous ICH, measured platelet activity (VerifyNow-ASA, Accumetrics) on admission, and recorded antiplatelet medication use. ICH volume was calculated using computerized volumetric analysis. Data were analyzed with nonparametric statistics and repeated measures ANOVA as appropriate. Patients were prospectively followed for functional outcomes. Data are presented as mean±SD or median [Q1 to Q3]. Results-Reduced platelet activity (≤550 aspirin reaction units [ARU]) was associated with increased ICH volume growth (P<0.05) for patients with the diagnostic CT within 12 hours. In the subset of patients not known to take aspirin, 24% had reduced platelet activity. Sixteen (24%) patients received a platelet transfusion 21.2±11.4 hours after symptom onset with an increase in platelet activity (448 [414-479] to 586 [530-639] ARU, P=0.001), but without impact on outcomes. Reduced platelet activity was associated with worse modified Rankin Scores at 3 months (P=0.02). Conclusions-Reduced platelet activity was associated with early ICH volume growth and worse functional outcome. Because platelet activity can be increased with platelet transfusion, increasing platelet activity is a potential method to reduce ICH volume growth and improve functional outcomes.

AB - Background and Purpose-Antiplatelet medication use and reduced platelet activity may be associated with mortality after intracerebral hemorrhage (ICH). We tested the hypothesis that reduced platelet activity is associated with early ICH clot growth and worse outcomes. Methods-We prospectively identified patients with spontaneous ICH, measured platelet activity (VerifyNow-ASA, Accumetrics) on admission, and recorded antiplatelet medication use. ICH volume was calculated using computerized volumetric analysis. Data were analyzed with nonparametric statistics and repeated measures ANOVA as appropriate. Patients were prospectively followed for functional outcomes. Data are presented as mean±SD or median [Q1 to Q3]. Results-Reduced platelet activity (≤550 aspirin reaction units [ARU]) was associated with increased ICH volume growth (P<0.05) for patients with the diagnostic CT within 12 hours. In the subset of patients not known to take aspirin, 24% had reduced platelet activity. Sixteen (24%) patients received a platelet transfusion 21.2±11.4 hours after symptom onset with an increase in platelet activity (448 [414-479] to 586 [530-639] ARU, P=0.001), but without impact on outcomes. Reduced platelet activity was associated with worse modified Rankin Scores at 3 months (P=0.02). Conclusions-Reduced platelet activity was associated with early ICH volume growth and worse functional outcome. Because platelet activity can be increased with platelet transfusion, increasing platelet activity is a potential method to reduce ICH volume growth and improve functional outcomes.

KW - ICH

KW - Intracranial hemorrhage

KW - Neurocritical care

KW - Platelets

UR - http://www.scopus.com/inward/record.url?scp=67650076520&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=67650076520&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.109.550939

DO - 10.1161/STROKEAHA.109.550939

M3 - Article

C2 - 19443791

AN - SCOPUS:67650076520

VL - 40

SP - 2398

EP - 2401

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 7

ER -