Abstract W MP88: Reduced Platelet Activity is Associated With Intraventricular Hematoma Clearance
Background: Reduction of intraventricular hematoma (IVH) burden is a novel therapeutic target for patients with intraventricular extension of intracerebral hemorrhage, yet little is known about clinical factors that may mediate IVH clearance. We tested the hypothesis that coagulation and platelet function abnormalities were associated with IVH clearance.
Methods: Patients with primary intracerebral hemorrhage were enrolled into a prospective registry between December 2006 and June 2013. We studied patients with IVH who underwent ventricular drainage and survived to discharge. Diagnostic and surveillance neuroimaging studies were analyzed for the presence of IVH and quantified by Graeb score. We used univariate analysis to select candidate variables (p<0.25) into a logistic regression model to identify clinical and radiographic factors independently associated with IVH clearance, defined as a decrease between highest to final Graeb score over up to 7 days. We assessed coagulation function by international normalized ratio (INR) and platelet function by aspirin reaction units (ARU), with decreasing ARU indicating aspirin-associated platelet dysfunction.
Results: There were 289 subjects in the cohort, of which 53 met inclusion criteria for this analysis. Univariate analysis identified age, hematoma volume, hydrocephalus, development of ventriculitis, INR, ARU, and observation interval between peak Graeb score and follow up imaging as potentially associated with IVH clearance. Multivariate modeling confirmed that platelet function by ARU (OR 0.990 IQR 0.992-0.998, p=0.019) and the observation interval (OR 1.024 per hour IQR 1.004-1.025, p=0.021) were independently associated with observing IVH clearance.
Conclusion: After correction for observation interval, aspirin-related platelet dysfunction is the clinical variable most strongly associated with IVH clearance in patients with intraventricular extension of intracerebral hemorrhage. These findings suggest an important interaction between platelet function and hematoma stability.
Author Disclosures: M.B. Maas: Other Research Support; Significant; NIH grant L30 NS080176. A.L. Romanova: None. M.D. Berman: None. J.C. Guth: None. E.M. Liotta: None. A.M. Naidech: None.
- © 2014 by American Heart Association, Inc.