The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy
Yıl: 2020 Cilt: 42 Sayı: 5 Sayfa Aralığı: 577 - 583 Metin Dili: İngilizce DOI: 10.20515/otd.605747 İndeks Tarihi: 03-05-2021
The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy
Öz: Thromboelastography (TEG) is a hemostatic test that measures the shear elasticity and the dynamics of clot formationand the strength and stability of formed clot. There are limited data about TEG in acute ischemic stroke who receives thrombolytictherapies. This study aimed to investigate the impact of coagulation parameters obtained by rotational thrombelastography(ROTEM) method on clinical outcome and intracerebral hemoorage in acute stroke patients receiving thrombolytic treatment. Thestudy included 29 patients with acute stroke who received rtPA treatment between June 2013 and March 2014. Blood samples weretaken from the patients before starting thrombolytic therapy. By ROTEM®; INTEM and EXTEM analysis, the parameters of CT(clotting time=sec), CFT (clot formation time=sec) and MCF (maximum clot firmness=mm) were tested. The demographicinformation of patients, NIHSS scores at the time and 24 hours after the admission and brain tomography results were recorded. Inaddition, the data obtained by ROTEM method were compared with the normal group. Compared to healthy group, ischemic strokepatients had lower intemCT (p<0.05), extemCT (p=0.01) and extemCFT (p<0.05) and higher extemMCF (p<0.05). These resultswere consistent with hypercoagulability. TEG parameters were not correlated with symptomatic hemorrhage, mortality and pooroutcome in patients who receive trombolytic treatment. Thrombelastography shows that patients with ischemic stroke are inhypercoagulable state. Further studies are needed to examine this observation and its relationship with clinical outcome.
Anahtar Kelime: Trombolitik Tedavi Alan Akut İ nmeli Hastalarda Tromboleastografi ile Klinik Sonlanım Arasındaki İ lişkinin Araştırılması
Öz: Tromboelastografi (TEG), pıhtı oluşumunun elastikiyetini ve dinamiklerini ve oluşan pıhtıların gücünü ve stabilitesini ölçen hemostatik bir testtir. Trombolitik tedavi alan akut iskemik inmede TEG hakkında sınırlı veri vardır. Bu çalışmada, trombolitik tedavi alan akut inmeli hastalarda rotasyonel trombelastografi (ROTEM) yöntemi ile elde edilen pıhtılaşma parametrelerinin klinik sonuç ve intraserebral kanama üzerine etkisi araştırıldı. Çalışma, Haziran 2013-Mart 2014 tarihleri arasında rtPA tedavisi alan akut inmeli 29 hasta içermiştir. Hastalardan trombolitik tedaviye başlamadan önce kan örnekleri alındı. ROTEM® ile; INTEM ve EXTEM analizi, CT (pıhtılaşma süresi = sn), CFT (pıhtı oluşum süresi = sn) ve MCF (maksimum pıhtı sertliği = mm) parametreleri test edildi. Hastaların demografik bilgileri, başvuru sırasındaki ve 24 saat sonra NIHSS skorları, 3.ay mRs ve beyin tomografi sonuçları kaydedildi. Ayrıca ROTEM yöntemiyle elde edilen veriler kontrol grup ile karşılaştırıldı.Sağlıklı gruba göre iskemik inme hastalarında düşük intemCT (p <0.05), extemCT (p = 0.01) ve extemCFT (p <0.05) ve daha yüksek extemMCF (p <0.05) vardı. Bu sonuçlar hiper pıhtılaşabilirlik ile tutarlıydı. TEG parametreleri, trombolitik tedavi alan hastalarda semptomatik kanama, mortalite ve 3 ay sonraki kötü klinik ile korele değildi. Trombelastografi, iskemik inmeli hastaların hiper pıhtılaşma durumunda olduğunu gösterir. Bu gözlemi ve klinik sonlanım ile ilişkisinin incelenmesi için daha ileri çalışmalar gereklidir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- 1. Shaydakov, M.E. and J. Blebea, Thromboelastography (TEG), in StatPearls. 2019: Treasure Island (FL).
- 2. Tanaka, K.A, et al. Rotational thromboelastometry (ROTEM)-based coagulation management in cardiac surgery and major trauma. J Cardiothorac Vasc Anesth, 2012. 26: p. 1083-93.
- 3. Lloyd-Jones, D, et al. Heart disease and stroke statistics--2009 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Circulation, 2009. 119: p. 480-6.
- 4. Hacke, W, et al. Thrombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med, 2008. 359: p. 1317-29.
- 5. Akay, O.M, et al. Laboratory investigation of hypercoagulability in cancer patients using rotation thrombelastography. Med Oncol, 2009. 26: p. 358-64.
- 6. Zivin, J.A, et al. Tissue plasminogen activator reduces neurological damage after cerebral embolism. Science, 1985. 230: p. 1289-92.
- 7. National Institute of Neurological, D. and P.A.S.S.G. Stroke rt, Tissue plasminogen activator for acute ischemic stroke. N Engl J Med, 1995. 333: p. 1581-7.
- 8. Jauch, E.C, et al. Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2013. 44: p. 870-947.
- 9. Hacke, W, et al. Randomised double-blind placebo-controlled trial of thrombolytic therapy with intravenous alteplase in acute ischaemic stroke (ECASS II). Second EuropeanAustralasian Acute Stroke Study Investigators. Lancet, 1998. 352: p. 1245-51.
- 10. Carroll, R.C, et al. Early evaluation of acute traumatic coagulopathy by thrombelastography. Transl Res, 2009. 154: p. 34-9.
- 11. Carroll, R.C, et al. A comparison of VerifyNowR with PlateletMappingR--detected aspirin resistance and correlation with urinary thromboxane. Anesth Analg, 2013. 116: p. 282-6.
- 12. Carroll, R.C., et al. Thrombelastography monitoring of resistance to enoxaparin anticoagulation in thrombophilic pregnancy patients. Thromb Res, 2007. 120: p. 367-70.
- 13. Andrea Elliott., et al Thromboelastography in Patients with Acute Ischemic Stroke. Int J Stroke. 2015 Feb; 10: 194–201.
| APA | ozakin e, Ozdemir A, Goren Sahin D, AKAY O, dinç y, Cevik A, Acar N, KAYA F, Bilgin M (2020). The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy. , 577 - 583. 10.20515/otd.605747 |
| Chicago | ozakin engin,Ozdemir Atilla Ozcan,Goren Sahin Deniz,AKAY Olga Meltem,dinç yasemin,Cevik Arif Alper,Acar Nurdan,KAYA FILIZ,Bilgin Muzaffer The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy. (2020): 577 - 583. 10.20515/otd.605747 |
| MLA | ozakin engin,Ozdemir Atilla Ozcan,Goren Sahin Deniz,AKAY Olga Meltem,dinç yasemin,Cevik Arif Alper,Acar Nurdan,KAYA FILIZ,Bilgin Muzaffer The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy. , 2020, ss.577 - 583. 10.20515/otd.605747 |
| AMA | ozakin e,Ozdemir A,Goren Sahin D,AKAY O,dinç y,Cevik A,Acar N,KAYA F,Bilgin M The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy. . 2020; 577 - 583. 10.20515/otd.605747 |
| Vancouver | ozakin e,Ozdemir A,Goren Sahin D,AKAY O,dinç y,Cevik A,Acar N,KAYA F,Bilgin M The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy. . 2020; 577 - 583. 10.20515/otd.605747 |
| IEEE | ozakin e,Ozdemir A,Goren Sahin D,AKAY O,dinç y,Cevik A,Acar N,KAYA F,Bilgin M "The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy." , ss.577 - 583, 2020. 10.20515/otd.605747 |
| ISNAD | ozakin, engin vd. "The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy". (2020), 577-583. https://doi.org/10.20515/otd.605747 |
| APA | ozakin e, Ozdemir A, Goren Sahin D, AKAY O, dinç y, Cevik A, Acar N, KAYA F, Bilgin M (2020). The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy. Osmangazi Tıp Dergisi, 42(5), 577 - 583. 10.20515/otd.605747 |
| Chicago | ozakin engin,Ozdemir Atilla Ozcan,Goren Sahin Deniz,AKAY Olga Meltem,dinç yasemin,Cevik Arif Alper,Acar Nurdan,KAYA FILIZ,Bilgin Muzaffer The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy. Osmangazi Tıp Dergisi 42, no.5 (2020): 577 - 583. 10.20515/otd.605747 |
| MLA | ozakin engin,Ozdemir Atilla Ozcan,Goren Sahin Deniz,AKAY Olga Meltem,dinç yasemin,Cevik Arif Alper,Acar Nurdan,KAYA FILIZ,Bilgin Muzaffer The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy. Osmangazi Tıp Dergisi, vol.42, no.5, 2020, ss.577 - 583. 10.20515/otd.605747 |
| AMA | ozakin e,Ozdemir A,Goren Sahin D,AKAY O,dinç y,Cevik A,Acar N,KAYA F,Bilgin M The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy. Osmangazi Tıp Dergisi. 2020; 42(5): 577 - 583. 10.20515/otd.605747 |
| Vancouver | ozakin e,Ozdemir A,Goren Sahin D,AKAY O,dinç y,Cevik A,Acar N,KAYA F,Bilgin M The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy. Osmangazi Tıp Dergisi. 2020; 42(5): 577 - 583. 10.20515/otd.605747 |
| IEEE | ozakin e,Ozdemir A,Goren Sahin D,AKAY O,dinç y,Cevik A,Acar N,KAYA F,Bilgin M "The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy." Osmangazi Tıp Dergisi, 42, ss.577 - 583, 2020. 10.20515/otd.605747 |
| ISNAD | ozakin, engin vd. "The Relationship Between Thromboelastography and Clinical Outcome in Acute Stroke Patients Receiving Thrombolytic Therapy". Osmangazi Tıp Dergisi 42/5 (2020), 577-583. https://doi.org/10.20515/otd.605747 |
