The relationship between thromboelastography and clinical outcome in acute stroke patients receiving thrombolytic therapy

Abstract

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.