Platelet Function Monitoring Performed after Carotid Stenting during Endovascular Stroke Treatment Predicts Outcome.
Aged
Aspirin
/ therapeutic use
Carotid Stenosis
/ blood
Clopidogrel
/ therapeutic use
Databases, Factual
Disability Evaluation
Drug Monitoring
Endovascular Procedures
/ adverse effects
Female
Humans
Intracranial Hemorrhages
/ chemically induced
Ischemic Stroke
/ blood
Male
Middle Aged
Platelet Aggregation
/ drug effects
Platelet Aggregation Inhibitors
/ adverse effects
Platelet Function Tests
Predictive Value of Tests
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Stents
Thrombosis
/ blood
Time Factors
Treatment Outcome
Carotid stent
Endovascular treatment
Ischemic stroke
Platelet aggregation
Platelet inhibitor
Journal
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
ISSN: 1532-8511
Titre abrégé: J Stroke Cerebrovasc Dis
Pays: United States
ID NLM: 9111633
Informations de publication
Date de publication:
Jul 2021
Jul 2021
Historique:
received:
07
01
2021
revised:
20
03
2021
accepted:
28
03
2021
pubmed:
9
5
2021
medline:
16
6
2021
entrez:
8
5
2021
Statut:
ppublish
Résumé
Many studies showed that platelet reactivity testing can predict ischemic events after carotid stenting or ischemic stroke. The aim of our study was to assess the role of early platelet function monitoring in predicting 90-days functional outcome, stent thrombosis and hemorrhagic transformation in patients with ischemic stroke treated with endovascular procedures requiring emergent extracranial stenting. We performed a retrospective study on consecutive patients with acute anterior circulation stroke admitted to our hospital between January 2015 and March 2020, in whom platelet reactivity testing was performed within 10 days from stenting. Patients were divided according to validated cutoffs in acetylsalicylic acid and Clopidogrel responders and not responders. Group comparison and regression analyses were performed to identify differences between groups and outcome predictors. We included in the final analysis 54 patients. Acetylsalicylic acid resistance was an independent predictor of poor 90 days outcome (OR for modified Rankin scale (mRS) ≤ 2: 0.10 95% CI: 0.02 - 0.69) whereas Clopidogrel resistance was an independent predictor of good outcome (OR for mRS ≤ 2: 7.09 95%CI: 1.33 - 37.72). Acetylsalicylic acid resistance was also associated with increased 90-days mortality (OR: 18.42; 95% CI: 1.67 - 203.14). We found a significant association between resistance to acetylsalicylic acid and poor 90-days functional outcome and between resistance to Clopidogrel and good 90-days functional outcome. If confirmed, our results might improve pharmacological management after acute carotid stenting.
Identifiants
pubmed: 33964545
pii: S1052-3057(21)00203-2
doi: 10.1016/j.jstrokecerebrovasdis.2021.105800
pii:
doi:
Substances chimiques
Platelet Aggregation Inhibitors
0
Clopidogrel
A74586SNO7
Aspirin
R16CO5Y76E
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
105800Informations de copyright
Copyright © 2021 Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest Andrea Zini has received consultancy and speaker fees from Boehringer-Ingelheim, Medtronic, Stryker, Daiichi Sankyo, Johnson&Johnson. The other authors have no conflicts of interest to declare.