Remote Assessment of Platelet Function in Patients with Acute Stroke or Transient Ischaemic Attack
Background. The TARDIS trial assessed the safety and efficacy of intensive versus guideline antiplatelet agents given for one month in patients with acute stroke or TIA. The aim of this substudy was to assess the effect of antiplatelet agents taken at baseline on platelet function reactivity and act...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Stroke Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2017/7365684 |
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| author | Philip M. Bath Jane May Katie Flaherty Lisa J. Woodhouse Natalia Dovlatova Sue C. Fox Timothy J. England Kailash Krishnan Thompson G. Robinson Nikola Sprigg Stan Heptinstall TARDIS Investigators |
| author_facet | Philip M. Bath Jane May Katie Flaherty Lisa J. Woodhouse Natalia Dovlatova Sue C. Fox Timothy J. England Kailash Krishnan Thompson G. Robinson Nikola Sprigg Stan Heptinstall TARDIS Investigators |
| author_sort | Philip M. Bath |
| collection | DOAJ |
| description | Background. The TARDIS trial assessed the safety and efficacy of intensive versus guideline antiplatelet agents given for one month in patients with acute stroke or TIA. The aim of this substudy was to assess the effect of antiplatelet agents taken at baseline on platelet function reactivity and activation. Methods. Platelet function, assessed by remotely measured surface expression of P-selectin, was assessed in patients at their time of randomisation. Data are median fluorescence values. Results. The aspirin P-selectin test demonstrated that platelet expression was lower in 494 patients taking aspirin than in 162 patients not: mean 210 (SD 188) versus 570 (435), difference 360.3 (95% CI 312.2–408.4) (2p<0.001). Aspirin did not suppress P-selectin levels below 500 units in 23 (4.7%) patients. The clopidogrel test showed that platelet reactivity was lower in 97 patients taking clopidogrel than in 585 patients not: 655 (296) versus 969 (315), difference 314.5 (95% CI 247.3–381.7) (2p<0.001). Clopidogrel did not suppress P-selectin level below 860 units in 24 (24.7%) patients. Conclusions. Aspirin and clopidogrel suppress stimulated platelet P-selectin, although one-quarter of patients on clopidogrel have high on-treatment platelet reactivity. Platelet function testing may be performed remotely in the context of a large multicentre trial. Trial registration ISRCTN47823388. |
| format | Article |
| id | doaj-art-ce3cf3569b4b46028d8663d49ede7aba |
| institution | OA Journals |
| issn | 2090-8105 2042-0056 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke Research and Treatment |
| spelling | doaj-art-ce3cf3569b4b46028d8663d49ede7aba2025-08-20T02:19:30ZengWileyStroke Research and Treatment2090-81052042-00562017-01-01201710.1155/2017/73656847365684Remote Assessment of Platelet Function in Patients with Acute Stroke or Transient Ischaemic AttackPhilip M. Bath0Jane May1Katie Flaherty2Lisa J. Woodhouse3Natalia Dovlatova4Sue C. Fox5Timothy J. England6Kailash Krishnan7Thompson G. Robinson8Nikola Sprigg9Stan Heptinstall10TARDIS Investigators11Stroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Nottingham NG5 1PB, UKPlatelet Solutions Ltd., Division of Clinical Neuroscience, University of Nottingham, Queen’s Medical Centre Campus, Nottingham NG7 2UH, UKStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Nottingham NG5 1PB, UKStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Nottingham NG5 1PB, UKPlatelet Solutions Ltd., Division of Clinical Neuroscience, University of Nottingham, Queen’s Medical Centre Campus, Nottingham NG7 2UH, UKPlatelet Solutions Ltd., Division of Clinical Neuroscience, University of Nottingham, Queen’s Medical Centre Campus, Nottingham NG7 2UH, UKVascular Medicine, Division of Medical Sciences and GEM, School of Medicine, University of Nottingham, Nottingham, UKStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Nottingham NG5 1PB, UKDepartment of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Leicester LE3 9QP, UKStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, City Hospital Campus, Nottingham NG5 1PB, UKPlatelet Solutions Ltd., Division of Clinical Neuroscience, University of Nottingham, Queen’s Medical Centre Campus, Nottingham NG7 2UH, UKUniversity of Nottingham, Nottingham, UKBackground. The TARDIS trial assessed the safety and efficacy of intensive versus guideline antiplatelet agents given for one month in patients with acute stroke or TIA. The aim of this substudy was to assess the effect of antiplatelet agents taken at baseline on platelet function reactivity and activation. Methods. Platelet function, assessed by remotely measured surface expression of P-selectin, was assessed in patients at their time of randomisation. Data are median fluorescence values. Results. The aspirin P-selectin test demonstrated that platelet expression was lower in 494 patients taking aspirin than in 162 patients not: mean 210 (SD 188) versus 570 (435), difference 360.3 (95% CI 312.2–408.4) (2p<0.001). Aspirin did not suppress P-selectin levels below 500 units in 23 (4.7%) patients. The clopidogrel test showed that platelet reactivity was lower in 97 patients taking clopidogrel than in 585 patients not: 655 (296) versus 969 (315), difference 314.5 (95% CI 247.3–381.7) (2p<0.001). Clopidogrel did not suppress P-selectin level below 860 units in 24 (24.7%) patients. Conclusions. Aspirin and clopidogrel suppress stimulated platelet P-selectin, although one-quarter of patients on clopidogrel have high on-treatment platelet reactivity. Platelet function testing may be performed remotely in the context of a large multicentre trial. Trial registration ISRCTN47823388.http://dx.doi.org/10.1155/2017/7365684 |
| spellingShingle | Philip M. Bath Jane May Katie Flaherty Lisa J. Woodhouse Natalia Dovlatova Sue C. Fox Timothy J. England Kailash Krishnan Thompson G. Robinson Nikola Sprigg Stan Heptinstall TARDIS Investigators Remote Assessment of Platelet Function in Patients with Acute Stroke or Transient Ischaemic Attack Stroke Research and Treatment |
| title | Remote Assessment of Platelet Function in Patients with Acute Stroke or Transient Ischaemic Attack |
| title_full | Remote Assessment of Platelet Function in Patients with Acute Stroke or Transient Ischaemic Attack |
| title_fullStr | Remote Assessment of Platelet Function in Patients with Acute Stroke or Transient Ischaemic Attack |
| title_full_unstemmed | Remote Assessment of Platelet Function in Patients with Acute Stroke or Transient Ischaemic Attack |
| title_short | Remote Assessment of Platelet Function in Patients with Acute Stroke or Transient Ischaemic Attack |
| title_sort | remote assessment of platelet function in patients with acute stroke or transient ischaemic attack |
| url | http://dx.doi.org/10.1155/2017/7365684 |
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