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Tytuł pozycji:

Platelet Function Monitoring Performed after Carotid Stenting during Endovascular Stroke Treatment Predicts Outcome.

Tytuł:
Platelet Function Monitoring Performed after Carotid Stenting during Endovascular Stroke Treatment Predicts Outcome.
Autorzy:
Ciolli L; Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Via Giardini 1355, Modena, Emilia Romagna 41126, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Lelli N; Laboratory of Clinical Pathology and Toxicology, Department of Laboratory Medicine, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Modena, Italy.
Rosafio F; Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Via Giardini 1355, Modena, Emilia Romagna 41126, Italy.
Maffei S; Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Via Giardini 1355, Modena, Emilia Romagna 41126, Italy.
Sacchetti F; Neuroradiology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Modena, Italy.
Vandelli L; Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Via Giardini 1355, Modena, Emilia Romagna 41126, Italy.
Dell'Acqua ML; Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Via Giardini 1355, Modena, Emilia Romagna 41126, Italy.
Picchetto L; Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Via Giardini 1355, Modena, Emilia Romagna 41126, Italy.
Borzì GM; Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Via Giardini 1355, Modena, Emilia Romagna 41126, Italy.
Ricceri R; Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Via Giardini 1355, Modena, Emilia Romagna 41126, Italy.
Pentore R; Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Via Giardini 1355, Modena, Emilia Romagna 41126, Italy.
Tondelli M; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Vandelli G; Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Via Giardini 1355, Modena, Emilia Romagna 41126, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Rodríguez-Villatoro N; Stroke Unit, Department of Neurology, Hospital Vall d'Hebron, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain.
Meletti S; Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Via Giardini 1355, Modena, Emilia Romagna 41126, Italy; Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Zini A; IRCCS Istituto delle Scienze Neurologiche di Bologna, Department of Neurology and Stroke Center, Maggiore Hospital, Bologna, Italy.
Vallone S; Neuroradiology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Modena, Italy.
Bigliardi G; Stroke Unit, Neurology Unit, Department of Neuroscience, Ospedale Civile, Azienda Ospedaliera Universitaria di Modena, Via Giardini 1355, Modena, Emilia Romagna 41126, Italy. Electronic address: .
Źródło:
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association [J Stroke Cerebrovasc Dis] 2021 Jul; Vol. 30 (7), pp. 105800. Date of Electronic Publication: 2021 May 05.
Typ publikacji:
Journal Article; Multicenter Study
Język:
English
Imprint Name(s):
Publication: Philadelphia, PA : Saunders
Original Publication: New York, NY : Demos Publications, [1991-
MeSH Terms:
Drug Monitoring*
Endovascular Procedures*/adverse effects
Endovascular Procedures*/instrumentation
Platelet Function Tests*
Carotid Stenosis/*therapy
Ischemic Stroke/*therapy
Platelet Aggregation/*drug effects
Platelet Aggregation Inhibitors/*therapeutic use
Aged ; Aspirin/therapeutic use ; Carotid Stenosis/blood ; Carotid Stenosis/diagnosis ; Clopidogrel/therapeutic use ; Databases, Factual ; Disability Evaluation ; Female ; Humans ; Intracranial Hemorrhages/chemically induced ; Ischemic Stroke/blood ; Ischemic Stroke/diagnosis ; Male ; Middle Aged ; Platelet Aggregation Inhibitors/adverse effects ; Predictive Value of Tests ; Registries ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Stents ; Thrombosis/blood ; Thrombosis/etiology ; Thrombosis/prevention & control ; Time Factors ; Treatment Outcome
Contributed Indexing:
Keywords: Carotid stent; Endovascular treatment; Ischemic stroke; Platelet aggregation; Platelet inhibitor
Substance Nomenclature:
0 (Platelet Aggregation Inhibitors)
A74586SNO7 (Clopidogrel)
R16CO5Y76E (Aspirin)
Entry Date(s):
Date Created: 20210508 Date Completed: 20210615 Latest Revision: 20210615
Update Code:
20240105
DOI:
10.1016/j.jstrokecerebrovasdis.2021.105800
PMID:
33964545
Czasopismo naukowe
Objectives: 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.
Materials and Methods: 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.
Results: 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).
Conclusion: 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.
Competing Interests: 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.
(Copyright © 2021 Elsevier Inc. All rights reserved.)

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