title: Aspirin Response Test role in platelet transfusion following intracerebral hemorrhage.
abstract: OBJECTIVE
  Spontaneous intracerebral hemorrhage (ICH) results in high morbidity and mortality. A target for therapy might be hematoma expansion, which occurs in a significant proportion of patients, and can be exacerbated by antiplatelet medications, such as aspirin. It is not clear whether platelet transfusion neutralizes aspirin. The Aspirin Response Test (ART) is commonly ordered in this patient population, but it is not clear whether the results of this test can help select patients for transfusion of platelets. The aim of our study is to investigate whether a selected group of ICH patients, those with reduced platelet activity ("aspirin responders"), will benefit from platelet transfusion.
  
  
  METHODS
  This retrospective study included 63 patients who were taking aspirin but no other antithrombotic medication prior to the ICH. For each patient, we measured hematoma size by head CT on admission and compared with follow-up head CT 1 day later.
  
  
  RESULTS
  In the general cohort, 41% of transfused patients and 29% of non-transfused patients had a hematoma expansion. In the "aspirin responders" group, 46% of transfused patients and 22% of non-transfused patients had an expansion.
  
  
  CONCLUSIONS
  Our data suggest that platelet transfusion following an ICH in "aspirin responders" does not reduce hematoma expansion rates in those patients. A larger prospective study is needed.
authors.affiliation: Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: einateng@post.tau.ac.il.
authors.forename: Einat
authors.initials: E
authors.lastname: Engel-Haber
authors.affiliation: University of Pittsburgh Medical Center, Department of Neurology, Pittsburgh, PA, United States.
authors.forename: Anat
authors.initials: A
authors.lastname: Horev
authors.affiliation: Ohio State University College of Medicine, Columbus, OH, United States.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Chablani
authors.affiliation: Tel Aviv Sourasky Medical Center, Department of Neurology, Tel Aviv University, Tel Aviv, Israel.
authors.forename: Natan M
authors.initials: NM
authors.lastname: Bornstein
authors.affiliation: University of Pittsburgh Medical Center, Department of Neurology, Pittsburgh, PA, United States.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Jadhav
authors.affiliation: University of Pittsburgh Medical Center, Department of Neurology, Pittsburgh, PA, United States.
authors.forename: Tudor G
authors.initials: TG
authors.lastname: Jovin
authors.affiliation: University of Pittsburgh Medical Center, Department of Neurology, Pittsburgh, PA, United States.
authors.forename: Vivek
authors.initials: V
authors.lastname: Reddy
authors.affiliation: University of Pittsburgh Medical Center, Department of Neurology, Pittsburgh, PA, United States.
authors.forename: Maxim D
authors.initials: MD
authors.lastname: Hammer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use*; D002543:Cerebral Hemorrhage / Q000188:drug therapy* / Q000628:therapy; D005260:Female; D006406:Hematoma / Q000175:diagnosis / Q000188:drug therapy* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D017713:Platelet Transfusion / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin
keywords: Aspirin; Aspirin Response Test; Intracerebral hemorrhage; Platelet response test; Platelet transfusion; Platelets; Reduced platelet activity