Author + information
- Paul A. Gurbela,b,
- Kevin Blidena,b,
- Trish Brannana,b,
- Carlos Lopez-Espinaa,b,
- Christopher McLeoda,b,
- Eli Cohena,b,
- Gabriel Raviva,b,
- Adina Muresana,b,
- Udaya Tantrya,b and
- John Cochrana,b
Background: Early assessment of antithrombotic effects may be important for therapeutic decision making in patients presenting with stroke and TIA.
Methods: In this prospective observational study, 80 patients presenting with symptoms suggestive of stroke and 45 patients with stroke-like symptoms were included. Acute ischemic stroke (AIS) was diagnosed in18 patients, intracerebral hemorrhage [ICH] in 8, transient ischemic attack (TIA) in 9 and stroke mimics (SM) in 10. TEG 6s, a new point-of-care assay with direct oral anticoagulant (DOAC) and Platelet Mapping cartridges were used to assess anti-thrombotic and thrombolytic therapy.
Results: Time to initial clot formation (R) was shorter in the AIS (p=0.009) vs. TIA, ICH, and SM. 50% of ICH patients were on DOACs and were responsive to therapy as defined by either Xa activity level and/or extended R. 50% of AIS patients were on either aspirin (n=4) or P2Y12 (n=5) monotherapy; patients on aspirin demonstrated 0-30% inhibition and all patients exhibited ≥30% inhibition to P2Y12 therapy. Patients receiving TPA had significant reduction in tensile clot strength (MA) and near complete lysis (LY30) at 30 minutes which normalized within 2 hours after treatment.
Conclusions: AIS is associated with faster ex vivo clot formation. Excessive anticoagulation may play a role in ICH and poor ASA response may contribute to AIS. This pilot data suggests that the TEGS-6S may be a useful tool for stroke type identification and measuring antithrombotic drug response.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: From Diet to Drugs: Mechanistic Insight Into Ischemic Heart Disease
Abstract Category: 1. Acute and Stable Ischemic Heart Disease: Basic
Presentation Number: 1202-302
- 2017 American College of Cardiology Foundation