• Journal of critical care · Apr 2020

    Randomized Controlled Trial

    Low dose Iloprost effect on platelet aggregation in comatose out-of-hospital cardiac arrest patients: A predefined sub-study of the ENDO-RCA randomized -phase 2- trial.

    • Meyer A S P ASP Section for Transfusion Medicine, Blood Bank, Rigshospitalet, 2034, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; Dept. of Cardiology, Copenhagen University, S R Ostrowski, J Kjærgaard, M Frydland, J H Thomsen, P I Johansson, and C Hassager.
    • Section for Transfusion Medicine, Blood Bank, Rigshospitalet, 2034, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; Dept. of Cardiology, Copenhagen University Rigshospitalet, 2143, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. Electronic address: anna.sina.pettersson.meyer.02@regionh.dk.
    • J Crit Care. 2020 Apr 1; 56: 197-202.

    PurposeThis is a predefined sub-study of the Endothelial Dysfunction in Resuscitated Cardiac Arrest (ENDO-RCA) trial. We aim to investigate Iloprost, a prostacyclin analogue, safety by evaluating change in whole blood platelet aggregometry (Multiplate) in out of hospital cardiac arrest (OHCA) patients from baseline to 96-h post randomization.MethodsA randomized, placebo controlled double-blinded trial in 46 OHCA patients. Patients were allocated 1:2 to 48 h Iloprost infusion, (1 ng/kg/min) or placebo (saline infusion). Platelet aggregation was determined by platelet aggregation tests ASPI-test (arachidonic acid); TRAP-test (thrombin-receptor activating peptide (TRAP)-6; RISTO test (Ristocetin); ADP test (adenosin diphosphat).ResultsThere was no significant difference between the iloprost and placebo groups according to ASPI, TRAP, RISTO and ADP platelet aggregation assays. Further, no significant differences regarding risk of bleeding were found between groups (Risk of bleeding: ASPI <40 U; TRAP <92 U; RISTO <35 U; ADP <50 U).ConclusionsIn conclusion, the iloprost infusion did not influence platelet aggregation as evaluated by the ASPI, TRAP, RISTO and ADP assays. There was no increased risk of bleeding or transfusion therapy. A decline in platelet aggregation was observed for the ASPI and ADP assays during the initial 96 h after OHCA.Trial RegistrationTrial registration at clinicaltrials.gov (identifier NCT02685618) on 18-02-2016.Copyright © 2020 Elsevier Inc. All rights reserved.

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