Evidence map›Paper›PMID 34708342›Full record

ArticleNeurocritical care2022

Antiplatelet Medications and Biomarkers of Hemostasis May Explain the Association of Hematoma Appearance and Subsequent Hematoma Expansion After Intracerebral Hemorrhage.

Mengxuan Tang, Hye Jung Shin, William Metcalf-Doetsch, Yuan Luo, Paul F Lindholm, Hau Kwaan, Andrew M Naidech

Abstract read
In one paragraph

Article in Neurocritical care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

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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

1 citing paper in PubMed.

  1. Article
4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Mengxuan TangDepartment of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Hye Jung ShinInstitute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
William Metcalf-DoetschDepartment of Neurosurgery, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Yuan LuoDivision of Health and Biomedical Informatics, Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Paul F LindholmDepartment of Pathology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Hau KwaanDivision of Hematology and Oncology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
Andrew M NaidechDepartment of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. a-naidech@northwestern.edu.ORCID http://orcid.org/0000-0003-1065-5417

Funding

Northwestern University Clinical and Translational Science Institute (NUCATS)UL1TR001422 · NCATS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI D'AQUILA, RICHARD · 2015 to 2023
$56.8M
Making Acute Stroke Trials Succeed: Challenges and Potential SolutionsU01NS110772 · NINDS · UNIVERSITY OF CINCINNATI · PI Joseph Paul Broderick, Jordan J. Elm · 2020 to 2026
$24.3M
Hemostasis, Hematoma Expansion, and Outcomes After Intracerebral HemorrhageR01NS110779 · NINDS · NORTHWESTERN UNIVERSITY AT CHICAGO · PI NAIDECH, ANDREW M · 2019 to 2023
$3.3M
NCATS NIH HHS UL1 TR001422NINDS NIH HHS R01 NS110779NINDS NIH HHS U01 NS110772
6 · The paper itself

Abstract

backgroundTo test the hypothesis that appearances of intracranial hematomas on diagnostic computed tomography (CT) are not idiosyncratic and reflect a biologically plausible mechanism, we evaluated the association between hematoma appearance on CT, biomarkers of platelet activity, and antiplatelet or anticoagulant medication use prior to admission.

methodsWe studied 330 consecutively identified patients from 2006 to 2019. Biomarkers of platelet activity (platelet aspirin assay) and medication history (aspirin, clopidogrel) were prospectively recorded on admission. A blinded interpreter recorded the presence of hematoma appearances from the diagnostic scan. Associations were tested with parametric or nonparametric statistics, as appropriate.

resultsThe black hole sign (101, 30%) was most prevalent, followed by the island sign (57, 17%) and blend sign (32, 10%). There was reduced platelet activity in patients with a black hole sign (511 [430-610] vs. 562 [472-628] aspirin reaction units, P = 0.01) or island sign (505 [434-574] vs. 559 [462-629] aspirin reaction units, P = 0.004). Clopidogrel use prior to admission was associated with the black hole sign (odds ratio 2.25, 95% confidence interval 1.02-4.98, P = 0.04).

conclusionsIn patients with acute intracerebral hemorrhage, hematoma appearances on CT are associated with biomarkers of platelet activity and clopidogrel use prior to admission. Appearances of intracranial hematomas on CT may reflect reduced hemostasis from antiplatelet medication use.

Indexed as

Cerebral HemorrhageHematomaAspirinBiomarkersClopidogrelDisease ProgressionHemostasisHumansPlatelet Aggregation InhibitorsAspirinBiomarkersClopidogrelPlatelet Aggregation InhibitorsComputed tomographyHemostasisIntracerebral hemorrhage

Identifiers

PMID34708342
PMCPMC10084720

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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.