Abstract Number: PB0108
Meeting: ISTH 2020 Congress
Background: Non-traumatic intracerebral hemorrhage (ICH) accounts for 10-15% of all strokes and results in a higher rate of mortality as compared to ischemic strokes.
Aims: In the IRONHEART study we aimed to find out whether the in vitro clot lysis assay or a modified method including the effect of neutrophil extracellular traps (NETs) might predict ICH outcomes.
Methods: In this prospective, observational study, 63 consecutive ICH patients were enrolled. Exclusion criteria included aneurysm rupture, cancer, liver or kidney failure, hemorrhagic diathesis or anticoagulant therapy. On admission, detailed clinical and laboratory investigations were performed. Bleeding volume was estimated based on CT performed on admission, day 1 and 2. In vitro clot lysis assay was carried out from stored platelet-free plasma of each patient taken on admission. A modified method was also performed including cell-free-DNA and histones in order to mimick the effect of NETs. Short- and long-term outcomes of ICH were defined at 14 days and 3 months post-event according to the NIHSS and the modified Rankin Scale (mRS), respectively. All patients or their relatives provided written informed consent.
Results: Modification of the clot lysis assay by adding cell-free-DNA and histones resulted in prolonged clot lysis times and significantly higher area-under-the-curve (AUC) values. Stroke severity was not associated with clot lysis time results of either assays. Using the modified clot lysis assay, median time to reach 50% clot lysis (50%CLT) showed a step-wise decrease in case of adverse long-term outcomes (mRS 0-1: median:62 [IQR:46-69] min; mRS 2-5: median:39 [IQR:28-46] min and mRS 6: median:36 [IQR:30-43] min, p=0.0018). Estimated intracerebral hemorrhage volume showed a negative correlation with the modified clot lysis assay lag time (r=-0.3489, p=0.0059) and 10%CLT (r=-0.3443, p=0.0066).
Conclusions: A clot-lysis assay might be useful to predict outcomes of ICH, particularly when the assay is supplemented with cell-free-DNA and histones.
To cite this abstract in AMA style:Orbán-Kálmándi R, Árokszállási T, Fekete I, Fekete K, Héja M, Tóth J, Sarkady F, Csiba L, Bagoly Z. The Use of in Vitro Clot Lysis Assay for Predicting Outcomes in Non-traumatic Intracerebral Hemorrhage Stroke Patients [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/the-use-of-in-vitro-clot-lysis-assay-for-predicting-outcomes-in-non-traumatic-intracerebral-hemorrhage-stroke-patients/. Accessed January 28, 2022.
« Back to ISTH 2020 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/the-use-of-in-vitro-clot-lysis-assay-for-predicting-outcomes-in-non-traumatic-intracerebral-hemorrhage-stroke-patients/