Evidence map›Paper›PMID 32973115›Full record

ArticleStroke and vascular neurology2021

Remote platelet function testing using P-selectin expression in patients with recent cerebral ischaemia on clopidogrel.

Jason Philip Appleton, Carla Richardson, Natalia Dovlatova, Jane May, Nikola Sprigg, Stan Heptinstall, Philip M Bath

Open access · goldAbstract read
In one paragraph

Article in Stroke and vascular neurology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. The Role of P-Selectin in COVID-19 Coagulopathy: An Updated Review.International journal of molecular sciences · 2021
    Pooled it
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 2 institutions in 1 country.

Jason Philip AppletonStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.ORCID 0000-0002-2604-4410
Carla RichardsonStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Natalia DovlatovaPlatelet Solutions Ltd, Division of Clinical Neuroscience, Queen's Medical Centre, University of Nottingham, Nottingham, UK.
Jane MayPlatelet Solutions Ltd, Division of Clinical Neuroscience, Queen's Medical Centre, University of Nottingham, Nottingham, UK.
Nikola SpriggStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK.
Stan HeptinstallPlatelet Solutions Ltd, Division of Clinical Neuroscience, Queen's Medical Centre, University of Nottingham, Nottingham, UK.
Philip M BathStroke Trials Unit, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK philip.bath@nottingham.ac.uk.
Nottingham University Hospitals NHS Trust · GBUniversity of Nottingham · GB

Funding

Department of Health 10/104/24
6 · The paper itself

Abstract

backgroundAntiplatelet agents reduce recurrence after cerebral ischaemia but are not effective in all patients, in part because of treatment resistance. The primary aim was to assess the proportion of patients who are insensitive to clopidogrel. The secondary aim was to assess the association between insensitivity to clopidogrel and recurrent cerebrovascular events.

methodsFollowing written informed consent, independent patients with a recent non-cardioembolic ischaemic stroke or transient ischaemic attack, and taking clopidogrel, were enrolled. Platelet function was assessed with remote measurement of surface expression of P-selectin (CD62P) using commercial kits sensitive to aspirin or clopidogrel. Participants' general practitioners provided details on recurrent vascular events at least 90 days later. Data are mean (SD) and median [IQR]. Resistance was defined as: aspirin median fluorescence (MF) >500 units, clopidogrel MF >860 units. Non-parametric descriptors and tests were used.

results63 patients were recruited: mean age 64 (13.7) years, women 47%. At baseline, 59 (95%) patients were taking clopidogrel alone with 3 (5%) on combined clopidogrel and aspirin. Assessment of platelet surface P-selectin revealed: aspirin test 528 [317, 834], >500 54.8%; clopidogrel test 429 [303, 656], >860 11.3%. No participants on aspirin and clopidogrel showed aspirin resistance. Thirteen (20.6%) patients had a recurrent cerebrovascular event; those with an ischaemic stroke had a non-significantly higher baseline P-selectin using the clopidogrel test as compared with those with no recurrence: 626 [380, 801] versus 406 [265, 609], p=0.08.

conclusionsRemote measurement of platelet function assessed using the platelet surface expression of P-selectin is feasible. 11% of patients taking clopidogrel showed resistance. No significant associations were noted between clopidogrel resistance and recurrent ischaemic events.

Indexed as

Brain IschemiaClopidogrelIschemic StrokeAgedDrug Therapy, CombinationFemaleHumansMaleMiddle AgedPlatelet Aggregation InhibitorsP-SelectinClopidogrelPlatelet Aggregation InhibitorsP-Selectinstroke

Identifiers

PMID32973115
PMCPMC8005903
OpenAlexW3042447872

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.