Remote Assessment of Platelet Function in Patients with Acute Stroke or Transient Ischaemic Attack.pdf (801.29 kB)
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Remote Assessment of Platelet Function in Patients with Acute Stroke or Transient Ischaemic Attack.

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journal contribution
posted on 17.11.2017, 15:02 by Philip M. Bath, Jane May, Katie Flaherty, Lisa J. Woodhouse, Natalia Dovlatova, Sue C. Fox, Timothy J. England, Kailash Krishnan, Thompson G. Robinson, Nikola Sprigg, Stan Heptinstall, TARDIS Investigators
BACKGROUND: The TARDIS trial assessed the safety and efficacy of intensive versus guideline antiplatelet agents given for one month in patients with acute stroke or TIA. The aim of this substudy was to assess the effect of antiplatelet agents taken at baseline on platelet function reactivity and activation. METHODS: Platelet function, assessed by remotely measured surface expression of P-selectin, was assessed in patients at their time of randomisation. Data are median fluorescence values. RESULTS: The aspirin P-selectin test demonstrated that platelet expression was lower in 494 patients taking aspirin than in 162 patients not: mean 210 (SD 188) versus 570 (435), difference 360.3 (95% CI 312.2-408.4) (2p < 0.001). Aspirin did not suppress P-selectin levels below 500 units in 23 (4.7%) patients. The clopidogrel test showed that platelet reactivity was lower in 97 patients taking clopidogrel than in 585 patients not: 655 (296) versus 969 (315), difference 314.5 (95% CI 247.3-381.7) (2p < 0.001). Clopidogrel did not suppress P-selectin level below 860 units in 24 (24.7%) patients. CONCLUSIONS: Aspirin and clopidogrel suppress stimulated platelet P-selectin, although one-quarter of patients on clopidogrel have high on-treatment platelet reactivity. Platelet function testing may be performed remotely in the context of a large multicentre trial. Trial registration ISRCTN47823388.

History

Citation

Stroke Research and Treatment, 2017, 2017, 7365684, 13 pp.

Author affiliation

/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Cardiovascular Sciences

Version

VoR (Version of Record)

Published in

Stroke Research and Treatment

Publisher

Hindawi Publishing Corporation

issn

2090-8105

eissn

2042-0056

Acceptance date

30/03/2017

Copyright date

2017

Available date

17/11/2017

Publisher version

https://www.hindawi.com/journals/srt/2017/7365684/

Language

en

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