Why the study?
Do reversal strategies such as platelet transfusions, desmopressin, or recombinant factor VIIa improve outcomes in patients with intracranial hemorrhage associated with antiplatelet agents?
Do reversal strategies such as platelet transfusions, desmopressin, or recombinant factor VIIa improve outcomes in patients with intracranial hemorrhage associated with antiplatelet agents?
There is currently no established strategy for reversing antiplatelet agents in the setting of intracranial hemorrhage, and evidence for interventions like platelet transfusions remains mixed.
No established reversal strategy for antiplatelet-associated ICH; leaves open optimal management pending randomized trials.
Patients are increasingly being prescribed antiplatelet agents (APAs) for a growing number of medical and surgical conditions. These agents are associated with an increased risk of hemorrhage, including intracranial hemorrhage (ICH). In the setting of warfarin use and ICH, strategies to reverse the drug effects have improved outcomes. No such strategy exists for APAs, and these patients continue to have poor posthemorrhage outcomes. One strategy is the use of platelet transfusions to provide functional, circulating platelets. Studies have shown mixed results regarding the benefit of this practice. Other strategies include the use of desmopressin and recombinant factor VIIa. More studies are necessary to delineate the effectiveness of the various strategies.
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Jaben et al. (2014) studied this question.
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