• J Stroke Cerebrovasc Dis · Nov 2018

    Coagulation Profile after Spontaneous Intracerebral Hemorrhage: A Cohort Study.

    • Signe Voigt Lauridsen, Anne-Mette Hvas, Emilie Sandgaard, Tua Gyldenholm, Christian Rahbek, Niels Hjort, Else Kirstine Tønnesen, and Christine Lodberg Hvas.
    • Department of Intensive Care, Aarhus University Hospital, Aarhus, Denmark. Electronic address: signevoigt@gmail.com.
    • J Stroke Cerebrovasc Dis. 2018 Nov 1; 27 (11): 2951-2961.

    BackgroundIntracerebral hemorrhage (ICH) causes death or disability and the incidence increases with age. Knowledge of acute hemostatic function in patients with ICH without anticoagulant and antiplatelet therapy is sparse. Increased knowledge of the coagulation profile in the acute phase of ICH could improve acute treatment and recovery. We investigated coagulation at admission and changes in coagulation during the first 24hours after symptom onset.MethodsEnrolled were 41 ICH patients without anticoagulant or antiplatelet therapy admitted to Aarhus University Hospital, Denmark. Blood samples were collected at admission, 6, and 24hours after symptom onset. Thromboelastometry (ROTEM), thrombin generation, and thrombin-antithrombin (TAT) complex were analyzed. Clinical outcome was evaluated using the National Institute of Health Stroke Scale, the Modified Rankin Score, and mortality.ResultsAt admission, compared with healthy individuals, ICH patients had increased maximum clot firmness (EXTEM P < .0001; INTEM P < .0001; FIBTEM P < .0001), increased platelet maximum clot elasticity (P < .0001) in ROTEM, higher peak thrombin (P < .0001) and endogenous thrombin potential (P = .01) in thrombin generation, and elevated TAT complex levels. During 24hours after significantly, while thrombin generation showed decreased peak thrombin (P < .0001) and endogenous thrombin potential (P < .0001). Coagulation test results did not differ between patients when stratified according to clinical outcome.ConclusionsICH patients without anticoagulant or antiplatelet therapy demonstrated activated coagulation at admission and within 24hours after symptom onset.Copyright © 2018. Published by Elsevier Inc.

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