Abstract Number: PB0094
Meeting: ISTH 2021 Congress
Theme: Coagulation and Natural Anticoagulants » Critical Care and Perioperative
Background: In practice of preventing secondary thrombotic complications, unfractionated heparins are used.
Aims: To assess the effectiveness of laboratory control over anticoagulant therapy in patients with acute stroke.
Methods: 27 patients (mean age 65.6±14.4) were examined. By the structure of neurological pathology: stroke was identified in 21 cases; cerebral venous sinus thrombosis was diagnosed in 2 cases, intracerebral hematoma was found in 2 cases; subarachnoid hemorrhage (SAH) was observed in 2 cases. Head computed tomography (CT), as well as CT – angiography, was made to all admitted patients. Ultrasonography of the brachiocephalic arteries, transcranial duplex scanning, echocardiography were also performed. Disaggregant therapy was not prescribed for patients with hemorrhagic stroke and SAH, anticoagulants in such cases were prescribed 72 hours after the development of a cerebral catastrophe, drug dosages were selected under the control of a coagulogram and Thrombodynamics (TD) test.
Results: Upon admission to ICU, the severity of the patient’s condition according to APACHE II scale was from 12 to 25 points, the median was 21 points. The severity of stroke was assessed by NIHSS scale and ranged from 0 to 19 points, the median was 9 points. On admission, the hemostasiogram indices were within the normal range. However, there was a significant increase of D-dimer level – 1.49 (1.90-5.68) mg/l (p <0.001) relative to the norm, as well as an increase of fibrinogen’s level – 4.26 (1.44-4.90) g/l. According to TD test, at the moment of admission the hemostasis system in patients was heterogeneous in terms of the dynamic characteristics Vi and Vst, as well as the size of the clot. 48% of patients were in the area of hypercoagulation of varying severity and 41% – in hypocoagulation state.
Conclusions: The global test “Thrombodynamics” is an effective tool for assessing the state of the plasma hemostasis and monitoring anticoagulant therapy during the treatment of patients.
To cite this abstract in AMA style:
Klychnikova E, Ramazanov G, Tazina E, Abudeev S, Vyshlova A. Control of Anti-coagulant Treatment in Patients with Acute Stroke by the Results of the «Thrombodynamics» Test [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/control-of-anti-coagulant-treatment-in-patients-with-acute-stroke-by-the-results-of-the-thrombodynamics-test/. Accessed March 22, 2024.« Back to ISTH 2021 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/control-of-anti-coagulant-treatment-in-patients-with-acute-stroke-by-the-results-of-the-thrombodynamics-test/