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In vitro analysis of platelet function in acute aneurysmal subarachnoid haemorrhage

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Abstract

Platelet function might play an essential role in the pathogenesis of delayed cerebral ischemia (DCI) after aneurysmal subarachnoid haemorrhage (SAH). Thus, impaired platelet function and disturbed primary haemostasis induced by intake of acetylsalicylic acid (ASA) might influence the rate of DCI. Primary haemostasis and platelet function can be measured with in vitro diagnosis (platelet function analyser test, PFA 100). The aim of this study is to evaluate the rate of DCI, haemorrhagic complications and the neurological outcome. Two groups were compared (patients with regular platelet function versus patients with impaired platelet function). This is a retrospective observational study. An initial cohort of 787 patients with SAH has been treated from January 2005 to September 2012. Seventy-nine patients (10%) with aneurysmal SAH, a history of ASA medication and PFA testing within the first 24 h after aneurysm rupture have been included. The overall rate of DCI in the present study was 43%. In vitro platelet function testing showed pathological primary haemostasis in 69.6%. The DCI rate was higher in patients with regular tested primary haemostasis (p = 0.02, OR = 3.16, 95%CI = [1.19; 8.83]). However, outcome assessment by mGOS did not show a significant difference between the groups. Patients with impaired primary haemostasis did not display a higher rate of haemorrhagic complications. Impairment of primary haemostasis resulting from an impairment of platelet function at an early stage after SAH might lead to a lower rate of DCI. In vitro testing of platelet function might be useful to predict the occurrence of DCI in the course.

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Authors and Affiliations

  1. Department of Neurosurgery, University Hospital of Göttingen, Robert Koch Strasse 40, 37075, Göttingen, Germany

    Christian von der Brelie & Veit Rohde

  2. Department of Neurosurgery, Medical Center, University of Bonn, Bonn, Germany

    Christian von der Brelie, Alexander Subai & Azize Boström

  3. Department of Clinical Chemistry, Section of Coagulation Disorders, University Hospital of Schleswig Holstein, Campus Kiel, Kiel, Germany

    Verena Limperger

  4. Institute of Medical Informatics and Statistics, Kiel University, Kiel, Germany

    Astrid Dempfle

Authors
  1. Christian von der Brelie
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  2. Alexander Subai
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  3. Verena Limperger
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  4. Veit Rohde
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  5. Astrid Dempfle
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  6. Azize Boström
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Correspondence to Christian von der Brelie.

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The manuscript was prepared in accordance with the declaration of Helsinki.

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The authors declare that they have no conflict of interest.

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von der Brelie, C., Subai, A., Limperger, V. et al. In vitro analysis of platelet function in acute aneurysmal subarachnoid haemorrhage. Neurosurg Rev 41, 531–538 (2018). https://doi.org/10.1007/s10143-017-0885-1

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  • DOI: https://doi.org/10.1007/s10143-017-0885-1

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