title: Reversing the effects of antiplatelet agents in the setting of intracranial hemorrhage: a look at the literature.
abstract: Patients are increasingly being prescribed antiplatelet agents (APAs) for a growing number of medical and surgical conditions. These agents are associated with an increased risk of hemorrhage, including intracranial hemorrhage (ICH). In the setting of warfarin use and ICH, strategies to reverse the drug effects have improved outcomes. No such strategy exists for APAs, and these patients continue to have poor posthemorrhage outcomes. One strategy is the use of platelet transfusions to provide functional, circulating platelets. Studies have shown mixed results regarding the benefit of this practice. Other strategies include the use of desmopressin and recombinant factor VIIa. More studies are necessary to delineate the effectiveness of the various strategies.
authors.affiliation: Division of Clinical Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Phoenix, AZ, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jaben
authors.affiliation: Division of Hematology-Oncology, University of Connecticut Health Center, Farmington, CT, USA.
authors.forename: Sudhanshu B
authors.initials: SB
authors.lastname: Mulay
authors.affiliation: Division of Transfusion Medicine, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA stubbs.james@mayo.edu.
authors.forename: James R
authors.initials: JR
authors.lastname: Stubbs
mesh_terms: D001241:Aspirin / Q000008:administration & dosage / Q000009:adverse effects*; D000077144:Clopidogrel; D003327:Coronary Disease / Q000188:drug therapy*; D004359:Drug Therapy, Combination; D015942:Factor VIIa / Q000627:therapeutic use*; D006801:Humans; D020300:Intracranial Hemorrhages / Q000139:chemically induced*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D017713:Platelet Transfusion; D011994:Recombinant Proteins / Q000627:therapeutic use; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D011994:Recombinant Proteins; D000077144:Clopidogrel; C103587:recombinant FVIIa; D015942:Factor VIIa; D013988:Ticlopidine; D001241:Aspirin
keywords: antiplatelet agents; aspirin; clopidogrel; intracranial hemorrhage; platelet transfusion