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Platelet dysfunction after Out of Hospital Cardiac Arrest. Results from POHCAR: A prospective observational, cohort study

Research output: Contribution to journalArticle

Original languageEnglish
Pages (from-to)105-111
Number of pages7
JournalResuscitation
Volume136
Early online date1 Feb 2019
DOIs
DateAccepted/In press - 20 Jan 2019
DateE-pub ahead of print - 1 Feb 2019
DatePublished (current) - Mar 2019

Abstract

AIM: Coagulation and platelet function following out of hospital cardiac arrest (OHCA) at admission to a UK cardiology centre were investigated prospectively in this observational feasibility study, and compared to that of patients receiving percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI).

METHOD: Blood samples taken immediately at emergency department admission from patients after OHCA of probable cardiac origin were analysed using near-patient thromboelastometry and a platelet function analyser. Physiological parameters, demographic information, bleeding rates and 30-day survival were recorded, and compared to that of patients undergoing PCI for STEMI.

RESULTS: Thirty patients were enrolled into each group. Platelet activation with thrombin receptor stimulation was reduced in OHCA patients compared to STEMI patients; mean TRAP AUC OHCA 79.3 (95% CI 63.7-94.9) vs STEMI 101.6 (95% CI 87.4-115.8), p = 0.03. The maximum clot firmness time was prolonged in the OHCA group compared to the STEMI group; 1718s (1545s-1906s) vs 1544s (1387s-1709s), p = 0.01. Other measures of clot formation and strength were comparable between groups. Hyperfibrinolysis (maximum lysis > = 15%) was common in both groups (57% in STEMI; 50% in OHCA) but did not increase 30-day bleeding risk.

CONCLUSION: OHCA patients demonstrated reduced thrombin receptor function at hospital admission but overall clot formation dynamics comparable to STEMI patients, indicating no gross coagulopathy post OHCA in our cohort. Hyperfibrinolysis was common both post OHCA and after STEMI. The results of this small feasibility study cannot draw clinical conclusions but will inform power calculations for future studies.

    Research areas

  • Bleeding, Cardiac arrest, Coagulation, Fibrinolysis, Platelets

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  • Full-text PDF (accepted author manuscript)

    Rights statement: This is the author accepted manuscript (AAM). The final published version (version of record) is available online via Elsevier at https://www.sciencedirect.com/science/article/pii/S030095721830858X . Please refer to any applicable terms of use of the publisher.

    Accepted author manuscript, 528 KB, PDF document

    Embargo ends: 1/02/20

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    Licence: CC BY-NC-ND

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