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

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

Research output: Contribution to journalArticle

7 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)459-470
Number of pages12
JournalTranslational Stroke Research
Volume9
Issue number5
DOIs
StatePublished - Oct 1 2018
Externally publishedYes

Keywords

  • Acute brain injury
  • Hemorrhagic stroke
  • Hypercoagulability
  • Reactive platelets
  • Stroke morbidity

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine

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    Ray, B., Pandav, V. M., Mathews, E. A., Thompson, D. M., Ford, L., Yearout, L. K., Bohnstedt, B. N., Chaudhary, S., Dale, G. L., & Prodan, C. I. (2018). Coated-Platelet Trends Predict Short-Term Clinical OutcomeAfter Subarachnoid Hemorrhage. Translational Stroke Research, 9(5), 459-470. https://doi.org/10.1007/s12975-017-0594-7