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Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke

We explored whether clot density in middle cerebral artery (MCA) occlusion is related to clinical variables, stroke etiology, blood constituents, and prestroke medication. We performed a retrospective chart review of patients with acute ischemic stroke of the anterior circulation admitted to two Cen...

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Autores principales: Pikija, Slaven, Magdic, Jozef, Lukic, Anita, Schreiber, Catharina, Mutzenbach, Johannes Sebastian, McCoy, Mark R., Sellner, Johann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037662/
https://www.ncbi.nlm.nih.gov/pubmed/27563874
http://dx.doi.org/10.3390/ijms17091382
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author Pikija, Slaven
Magdic, Jozef
Lukic, Anita
Schreiber, Catharina
Mutzenbach, Johannes Sebastian
McCoy, Mark R.
Sellner, Johann
author_facet Pikija, Slaven
Magdic, Jozef
Lukic, Anita
Schreiber, Catharina
Mutzenbach, Johannes Sebastian
McCoy, Mark R.
Sellner, Johann
author_sort Pikija, Slaven
collection PubMed
description We explored whether clot density in middle cerebral artery (MCA) occlusion is related to clinical variables, stroke etiology, blood constituents, and prestroke medication. We performed a retrospective chart review of patients with acute ischemic stroke of the anterior circulation admitted to two Central European stroke centers. The acquisition of non-contrast enhanced CT (NECT) and CT angiography (CTA) within 4.5 h of symptom onset was obligatory. We assessed the site of MCA occlusion as well as density, area, and length of the clot in 150 patients. The Hounsfield unit values for the clot were divided with contralateral MCA segment to yield relative Hounsfield Unit ratio (rHU). The site of the vessel occlusion (M1 vs. M2) and antiplatelet usage, but not stroke etiology, significantly influenced rHU. We found an inverse correlation of rHU with erythrocyte count (p < 0.001). The multivariate analysis revealed that a higher rHU (i.e., clot being more hyperdense) was more likely with the use of antiplatelets (OR 4.24, CI 1.10–16.31, p = 0.036). Erythrocyte (OR 0.18, CI 0.05–0.55, p = 0.003), and thrombocyte counts (OR 0.99, CI 0.98–0.99, p = 0.029) were associated with odds for more hypodense clots (lower rHU). Our study disclosed that antiplatelet therapy impacts the composition of intracranial clots of the anterior circulation.
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spelling pubmed-50376622016-09-29 Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke Pikija, Slaven Magdic, Jozef Lukic, Anita Schreiber, Catharina Mutzenbach, Johannes Sebastian McCoy, Mark R. Sellner, Johann Int J Mol Sci Article We explored whether clot density in middle cerebral artery (MCA) occlusion is related to clinical variables, stroke etiology, blood constituents, and prestroke medication. We performed a retrospective chart review of patients with acute ischemic stroke of the anterior circulation admitted to two Central European stroke centers. The acquisition of non-contrast enhanced CT (NECT) and CT angiography (CTA) within 4.5 h of symptom onset was obligatory. We assessed the site of MCA occlusion as well as density, area, and length of the clot in 150 patients. The Hounsfield unit values for the clot were divided with contralateral MCA segment to yield relative Hounsfield Unit ratio (rHU). The site of the vessel occlusion (M1 vs. M2) and antiplatelet usage, but not stroke etiology, significantly influenced rHU. We found an inverse correlation of rHU with erythrocyte count (p < 0.001). The multivariate analysis revealed that a higher rHU (i.e., clot being more hyperdense) was more likely with the use of antiplatelets (OR 4.24, CI 1.10–16.31, p = 0.036). Erythrocyte (OR 0.18, CI 0.05–0.55, p = 0.003), and thrombocyte counts (OR 0.99, CI 0.98–0.99, p = 0.029) were associated with odds for more hypodense clots (lower rHU). Our study disclosed that antiplatelet therapy impacts the composition of intracranial clots of the anterior circulation. MDPI 2016-08-23 /pmc/articles/PMC5037662/ /pubmed/27563874 http://dx.doi.org/10.3390/ijms17091382 Text en © 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pikija, Slaven
Magdic, Jozef
Lukic, Anita
Schreiber, Catharina
Mutzenbach, Johannes Sebastian
McCoy, Mark R.
Sellner, Johann
Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke
title Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke
title_full Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke
title_fullStr Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke
title_full_unstemmed Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke
title_short Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke
title_sort antiplatelet usage impacts clot density in acute anterior circulation ischemic stroke
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5037662/
https://www.ncbi.nlm.nih.gov/pubmed/27563874
http://dx.doi.org/10.3390/ijms17091382
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