Platelet infusion not effective after intracerebral haemorrhage associated with antiplatelet therapy

by Bruce Sylvester: Platelet transfusion after acute spontaneous primary intracerebral haemorrhage in people taking antiplatelet therapy appears to be less effective than standard care, researchers reported on June 25, 2016 in The Lancet.

“We aimed to investigate whether platelet transfusion with standard care, compared with standard care alone, reduced death or dependence after intracerebral haemorrhage associated with antiplatelet therapy use.”

The researchers performed the Phase III, open-label, masked-endpoint, randomized trial at 60 hospitals in the Netherlands, UK, and France.

Subjects were enrolled adults within 6 hours of supratentorial intracerebral haemorrhage symptom onset, if they had used antiplatelet therapy for at least 7 days beforehand and had a Glasgow Coma Scale score of at least 8.

Between Feb 4, 2009, and Oct 8, 2015, investigators enrolled 190 subjects;  97 were randomized to platelet transfusion and 93 to standard care

The primary outcome was shift towards death or dependence.

The researchers reported that odds of death or dependence at 3 months were significantly higher in the platelet transfusion group than in the standard care group (p=0·0114).

Also, 40 (42%) participants who received platelet transfusion had a serious adverse event during hospitalization, as did 28 (29%) who received standard care.

Twenty-three (24%) subjects assigned to platelet transfusion and 16 (17%) assigned to standard care died during hospital stay.

”Platelet transfusion cannot be recommended for this indication in clinical practice,”  the authors concluded.