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Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke

View Article: PubMed Central - PubMed

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus

Correlation of final infarct volume on non-contrast enhanced computed tomography (NECT) with relative clot density (rHU) in 133 stroke patients presenting within 4.5 h after symptom onset (p = 0.048). rHu—ratio between clot and contralateral vessel density.
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ijms-17-01382-f002: Correlation of final infarct volume on non-contrast enhanced computed tomography (NECT) with relative clot density (rHU) in 133 stroke patients presenting within 4.5 h after symptom onset (p = 0.048). rHu—ratio between clot and contralateral vessel density.

Mentions: A history of antiplatelet usage or rHU was not predictive of clinical outcome. There was a trend for lower rHU with greater final infarct volume (n = 139, p = 0.068). The correlation was significant when the patients with complete resolution were excluded (p = 0.048, n = 133, Figure 2).


Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke
Correlation of final infarct volume on non-contrast enhanced computed tomography (NECT) with relative clot density (rHU) in 133 stroke patients presenting within 4.5 h after symptom onset (p = 0.048). rHu—ratio between clot and contralateral vessel density.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037662&req=5

ijms-17-01382-f002: Correlation of final infarct volume on non-contrast enhanced computed tomography (NECT) with relative clot density (rHU) in 133 stroke patients presenting within 4.5 h after symptom onset (p = 0.048). rHu—ratio between clot and contralateral vessel density.
Mentions: A history of antiplatelet usage or rHU was not predictive of clinical outcome. There was a trend for lower rHU with greater final infarct volume (n = 139, p = 0.068). The correlation was significant when the patients with complete resolution were excluded (p = 0.048, n = 133, Figure 2).

View Article: PubMed Central - PubMed

ABSTRACT

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.

No MeSH data available.


Related in: MedlinePlus