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Prospective Evaluation of Blood Coagulability and Effect of Treatment in Patients with Stroke Using Rotational Thromboelastometry

Authors :
Roger H. K. Morris
Mushtaq Wani
Sophia N. Stanford
John F. Potter
Sharon Storton
Phillip A. Evans
Phylip Rhodri Williams
Karl Hawkins
Ahmed Sabra
Matthew Lawrence
Source :
Journal of Stroke and Cerebrovascular Diseases. 24:304-311
Publication Year :
2015
Publisher :
Elsevier BV, 2015.

Abstract

Background Stroke is the second largest cause of death worldwide. Abnormalities in hemostasis play an important role in the pathophysiology of ischemic stroke (IS). These hemostatic defects can be detected using rotational thromboelastometry (ROTEM) as a global method of measuring coagulation.This study assessed the effects of IS on blood hypercoagulability using ROTEM method, before and subsequent to therapeutic interventions. Methods In a prospective observational cohort study, whole blood coagulation using ROTEM, along with full blood count and standard coagulation tests, were compared between patients with IS and an age-matched control group of healthy volunteers. Further assessment took place at 2-4 hours and at 24 hours in the stroke group after therapy to assess the effects of therapeutic intervention. Results Seventy-two patients with IS were age-matched to 71 healthy subjects. Clotting time (CT) INTEM (P = .01) and maximum clot firmness (MCF) INTEM (P = .02) were significantly different between stroke patients at baseline and healthy subjects, but this difference disappeared when controlled for by smoking status. There was no association between ROTEM parameters and time from stroke symptom onset or stroke severity as reflected in The National Institute of Health Stroke Scale score. Significant but small changes in the values of MCF-EXTEM, clot formation time (CFT) EXTEM, and alpha-EXTEM CT were observed after therapeutic intervention (thrombolysis or aspirin treatment). Conclusions ROTEM testing does not seem to detect a hypercoagulable state in patients with IS. Nonetheless, some ROTEM parameters had a small change after antiplatelet therapy or thrombolysis.

Details

ISSN :
10523057
Volume :
24
Database :
OpenAIRE
Journal :
Journal of Stroke and Cerebrovascular Diseases
Accession number :
edsair.doi.dedup.....aac4848a4c23fd7c4a17cb0aa561e08d
Full Text :
https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.08.028