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January 1, 1998Stroke

Depressed Platelet Status in an Elderly Patient With Hemorrhagic Stroke After Thrombolysis for Acute Myocardial Infarction

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Population

86-year-old male patient with acute myocardial infarction on long-term aspirin who developed a hemorrhagic…

Comparison

Alteplase (thrombolysis) for AMI vs Other AMI patients treated with thrombolysis who…

Design

Case_report

Follow-up

44 hours

Authors

VSVictor L. SerebruanyGeneral / Preventive / LipidsPGPaul A. GurbelInterventional CardiologyASAndrew R. ShustovSaint Agnes Hospital

Discussion

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Implication

May flag hemorrhagic stroke risk after thrombolysis in long-term aspirin users; single case leaves open need for validation.

Structured PICO

P
Population
86-year-old male patient with acute myocardial infarction (AMI) on long-term aspirin (325 mg daily for ≥6 years) who developed a hemorrhagic stroke 44 hours after thrombolysis, compared to 22 other AMI patients in the GUSTO-III platelet study.
I
Intervention
Alteplase (thrombolysis) for AMI
C
Comparator
Other AMI patients (n=22) treated with thrombolysis who did not develop hemorrhagic stroke
O
Outcome
Platelet aggregation and receptor expression (glycoprotein Ib, IIb, IIIa, IIb/IIIa, vitronectin receptor, p24, VLA-2, P-selectin, PECAM-1) before thrombolysis and at 3, 6, 12, and 24 hourssurrogate

Profound depression of platelet status ('exhausted' platelets) may precede and increase the risk for hemorrhagic stroke after coronary thrombolysis in elderly long-term aspirin users.

Cite This Study

Serebruany et al. (1998) studied this question.

synapsesocial.com/papers/6a763eacb4bf63452708753ehttps://doi.org/10.1161/01.str.29.1.235

Topics

Dual antiplatelet therapy
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Enhanced in vivo platelet activation in subtypes of ischemic stroke.1985 · 131 citations
  2. 2Mediation of reocclusion by thromboxane A2 and serotonin after thrombolysis with tissue-type plasminogen activator in a canine preparation of coronary thrombosis.1988 · 151 citations
  3. 3Combination of platelet fibrinogen receptor antagonist and direct thrombin inhibitor at low doses markedly improves thrombolysis.1994 · 90 citations
  4. 4An International Randomized Trial Comparing Four Thrombolytic Strategies for Acute Myocardial Infarction1993 · 4,078 citations
  5. 5Stroke After Thrombolysis1995 · 323 citations