Objectives: Many studies showed that platelet reactivity testing can predict ischemic events after carotid stenting or ischemic stroke. The aim of our study was to assess the role of early platelet function monitoring in predicting 90-days functional outcome, stent thrombosis and hemorrhagic transformation in patients with ischemic stroke treated with endovascular procedures requiring emergent extracranial stenting. Materials and methods: We performed a retrospective study on consecutive patients with acute anterior circulation stroke admitted to our hospital between January 2015 and March 2020, in whom platelet reactivity testing was performed within 10 days from stenting. Patients were divided according to validated cutoffs in acetylsalicylic acid and Clopidogrel responders and not responders. Group comparison and regression analyses were performed to identify differences between groups and outcome predictors. Results: We included in the final analysis 54 patients. Acetylsalicylic acid resistance was an independent predictor of poor 90 days outcome (OR for modified Rankin scale (mRS) ≤ 2: 0.10 95% CI: 0.02 – 0.69) whereas Clopidogrel resistance was an independent predictor of good outcome (OR for mRS ≤ 2: 7.09 95%CI: 1.33 – 37.72). Acetylsalicylic acid resistance was also associated with increased 90-days mortality (OR: 18.42; 95% CI: 1.67 – 203.14). Conclusion: We found a significant association between resistance to acetylsalicylic acid and poor 90-days functional outcome and between resistance to Clopidogrel and good 90-days functional outcome. If confirmed, our results might improve pharmacological management after acute carotid stenting.

Platelet Function Monitoring Performed after Carotid Stenting during Endovascular Stroke Treatment Predicts Outcome / Ciolli, L.; Lelli, N.; Rosafio, F.; Maffei, S.; Sacchetti, F.; Vandelli, L.; Dell'Acqua, M. L.; Picchetto, L.; Borzi, G. M.; Ricceri, R.; Pentore, R.; Tondelli, M.; Vandelli, G.; Rodriguez-Villatoro, N.; Meletti, S.; Zini, A.; Vallone, S.; Bigliardi, G.. - In: JOURNAL OF STROKE AND CEREBROVASCULAR DISEASES. - ISSN 1052-3057. - 30:7(2021), pp. 105800_1-105800_8. [10.1016/j.jstrokecerebrovasdis.2021.105800]

Platelet Function Monitoring Performed after Carotid Stenting during Endovascular Stroke Treatment Predicts Outcome

Ciolli L.;Tondelli M.;Vandelli G.;Meletti S.;
2021

Abstract

Objectives: Many studies showed that platelet reactivity testing can predict ischemic events after carotid stenting or ischemic stroke. The aim of our study was to assess the role of early platelet function monitoring in predicting 90-days functional outcome, stent thrombosis and hemorrhagic transformation in patients with ischemic stroke treated with endovascular procedures requiring emergent extracranial stenting. Materials and methods: We performed a retrospective study on consecutive patients with acute anterior circulation stroke admitted to our hospital between January 2015 and March 2020, in whom platelet reactivity testing was performed within 10 days from stenting. Patients were divided according to validated cutoffs in acetylsalicylic acid and Clopidogrel responders and not responders. Group comparison and regression analyses were performed to identify differences between groups and outcome predictors. Results: We included in the final analysis 54 patients. Acetylsalicylic acid resistance was an independent predictor of poor 90 days outcome (OR for modified Rankin scale (mRS) ≤ 2: 0.10 95% CI: 0.02 – 0.69) whereas Clopidogrel resistance was an independent predictor of good outcome (OR for mRS ≤ 2: 7.09 95%CI: 1.33 – 37.72). Acetylsalicylic acid resistance was also associated with increased 90-days mortality (OR: 18.42; 95% CI: 1.67 – 203.14). Conclusion: We found a significant association between resistance to acetylsalicylic acid and poor 90-days functional outcome and between resistance to Clopidogrel and good 90-days functional outcome. If confirmed, our results might improve pharmacological management after acute carotid stenting.
2021
30
7
105800_1
105800_8
Platelet Function Monitoring Performed after Carotid Stenting during Endovascular Stroke Treatment Predicts Outcome / Ciolli, L.; Lelli, N.; Rosafio, F.; Maffei, S.; Sacchetti, F.; Vandelli, L.; Dell'Acqua, M. L.; Picchetto, L.; Borzi, G. M.; Ricceri, R.; Pentore, R.; Tondelli, M.; Vandelli, G.; Rodriguez-Villatoro, N.; Meletti, S.; Zini, A.; Vallone, S.; Bigliardi, G.. - In: JOURNAL OF STROKE AND CEREBROVASCULAR DISEASES. - ISSN 1052-3057. - 30:7(2021), pp. 105800_1-105800_8. [10.1016/j.jstrokecerebrovasdis.2021.105800]
Ciolli, L.; Lelli, N.; Rosafio, F.; Maffei, S.; Sacchetti, F.; Vandelli, L.; Dell'Acqua, M. L.; Picchetto, L.; Borzi, G. M.; Ricceri, R.; Pentore, R.;...espandi
File in questo prodotto:
File Dimensione Formato  
Platelet Function Monitoring Performed after Carotid Stenting during Endovascular Stroke Treatment Predicts Outcome1-s2.0-S1052305721002032-main.pdf

Accesso riservato

Tipologia: Versione pubblicata dall'editore
Dimensione 388.06 kB
Formato Adobe PDF
388.06 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

Licenza Creative Commons
I metadati presenti in IRIS UNIMORE sono rilasciati con licenza Creative Commons CC0 1.0 Universal, mentre i file delle pubblicazioni sono rilasciati con licenza Attribuzione 4.0 Internazionale (CC BY 4.0), salvo diversa indicazione.
In caso di violazione di copyright, contattare Supporto Iris

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1246418
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 1
  • ???jsp.display-item.citation.isi??? 1
social impact