title: Lower Coated-Platelet Levels Are Associated With Increased Mortality After Spontaneous Intracerebral Hemorrhage.
abstract: OBJECTIVE
  Coated-platelets are highly procoagulant platelets observed on dual-agonist stimulation with collagen and thrombin. Coated-platelet levels are decreased in patients with spontaneous intracerebral hemorrhage when compared with controls and inversely correlated with bleed volume. We sought to investigate whether coated-platelets are associated with increased mortality at 30 days after spontaneous intracerebral hemorrhage.
  
  
  METHODS
  Coated-platelet levels were assayed in 95 consecutive patients with spontaneous intracerebral hemorrhage. The main outcome was mortality at 30 days according to coated-platelet levels at enrollment. Subjects were grouped into tertiles of the observed coated-platelet level distribution. Groups defined by tertile of coated-platelet level were compared using either ANOVA or a Kruskal-Wallis test for small group size for continuous measures and an exact Cochrane-Armitage trend test for categorical measures. Logistic regression was used to estimate the adjusted odds of death within 30 days associated with coated-platelet levels.
  
  
  RESULTS
  Cumulative mortality at 30 days was 23% (22 subjects). Mortality at 30 days differed among the coated-platelet tertiles: 44% for the first tertile (lowest coated-platelet levels), 19% for the second tertile, and 6% for the third tertile (trend test; P=0.0004). Logistic regression examining the association between mortality and coated-platelet levels showed that the odds of death at 30 days in those with levels <27% (n=47) were 6.83× the odds for patients with levels ≥27% (95% confidence interval, 2.10-22.23).
  
  
  CONCLUSIONS
  These results support a link between impaired coated-platelet potential and outcome in intracerebral hemorrhage.
authors.affiliation: From the Departments of Neurology (C.I.P.), Biostatistics and Epidemiology (J.A.S.), and Medicine (G.L.D.), University of Oklahoma Health Sciences Center; and Department of Neurology, Veterans Affairs Medical Center, Oklahoma City, OK (C.I.P.). calin-prodan@ouhsc.edu.
authors.forename: Calin I
authors.initials: CI
authors.lastname: Prodan
authors.affiliation: From the Departments of Neurology (C.I.P.), Biostatistics and Epidemiology (J.A.S.), and Medicine (G.L.D.), University of Oklahoma Health Sciences Center; and Department of Neurology, Veterans Affairs Medical Center, Oklahoma City, OK (C.I.P.).
authors.forename: Julie A
authors.initials: JA
authors.lastname: Stoner
authors.affiliation: From the Departments of Neurology (C.I.P.), Biostatistics and Epidemiology (J.A.S.), and Medicine (G.L.D.), University of Oklahoma Health Sciences Center; and Department of Neurology, Veterans Affairs Medical Center, Oklahoma City, OK (C.I.P.).
authors.forename: George L
authors.initials: GL
authors.lastname: Dale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000378:metabolism*; D002543:Cerebral Hemorrhage / Q000097:blood* / Q000188:drug therapy / Q000401:mortality*; D003094:Collagen / Q000008:administration & dosage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D010979:Platelet Function Tests / Q000401:mortality; D011446:Prospective Studies; D012307:Risk Factors; D013917:Thrombin / Q000008:administration & dosage
chemical_list: D003094:Collagen; D013917:Thrombin
keywords: hemorrhage; platelets; stroke; thrombosis