Abstract T MP36: Association Of Thrombelastographic Parameters With Subsequent Ischemic Events After Intra/extracranial Stenting
Background and Purpose: Thrombelastography (TEG) is widely used for the measurement of platelet function. However, few studies have investigated the TEG parameters in patients receiving extracranial or intracranial stenting for ischemic cerebrovascular disease. This pilot study sought to describe the association of TEG parameters before procedure with post -procedural ischemic events after extracranial or intracranial stenting.
Methods: This was an institutional review board-approved prospective cohort study. Patients who had stenting performed for extracranial or intracranial stenosis (70%-99%) were recruited into the study. Blood samples were obtained for TEG to assess the platelet function before stenting. The primary end point was ischemic stroke or transient ischemic attack in the territory of the stented artery.
Results: A total of 218 patients were included in this study. During a mean follow up period of 132 days (98-226 days), 18 (8.26%, 18/218) primary end point events were recorded. Compared with patients without ischemic events, the ADP-induced platelet-fibrin clot strength (MAADP) was significantly higher (41.57±15.10 Vs 33.50±13.86, P=0.020), and the adenosine diphosphate (ADP) inhibition rate (ADP%) was significantly lower in patients with ischemic events (39.54 ±23.15 Vs 55.29±24.43, P=0.009). Multivariate analysis showed MAADP and ADP% were identified as significant independent predictors of subsequent ischemic events with hazard ratios of 1.036 and 0.965 respectively. From receiver operating characteristic curve analysis, MAADP>49.95mm had the best predictive value of ischemic events.
Conclusions: Our study suggests that MAADP and ADP% by TEG evaluation parameterswere associated with the subsequent ischemic events in patients with extracranial or intracranial stents.
Clinical Trial Registration-URL: http://www.clinicaltrials.gov. Unique identifier: NCT01925872.
Ischemic cerebrovascular disease
Author Disclosures: Z. Miao: None. N. Ma: None. B. Wang: None. X. Li: None.
- © 2015 by American Heart Association, Inc.