title: Clot Strength as Measured by Thrombelastography Correlates with Platelet Reactivity in Stroke Patients.
abstract: OBJECTIVE
  Platelet reactivity may be important in the management of patients with stroke. However, degree of platelet reactivity has not been correlated with Thrombelastography (TEG(®)) parameters in stroke. We sought to detect a correlation between TEG(®) values and clot platelet reactivity in ex vivo clots of stroke patients.
  
  
  METHODS
  We collected venous blood from 40 patients with stroke. TEG(®) measurements were carried out and residual clots were fixed in 10% formalin immediately following completion of TEG(®). The formalin specimens were embedded in paraffin blocks, cut at 4 micrometers, and stained with CD 61 (immunohistochemical stain used to detect platelets) with appropriate controls. Under light microscopy, three pathologists blinded to TEG(®) results independently graded CD61 intensity (how aggregated/intense the CD61 stained) into a low and high group, as a proposed measurement representing the platelet reactivity of the clot. We compared pre-tPA-TEG(®) values among groups with different CD 61 intensities.
  
  
  RESULTS
  After adjusting for confounding factors, we found statistically significant correlation between CD61 staining and several TEG(®) parameters (Delta and CD61 staining intensity (p=0.047); Angle and CD61 staining intensity grade (p=0.04); and G and CD61 staining intensity grade (p=0.04)).
  
  
  CONCLUSIONS
  Clot strength on TEG(®) as measured by Delta, Angle, and G correlates with a clot with greater platelet reactivity.
authors.affiliation: Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Richard S P
authors.initials: RS
authors.lastname: Huang
authors.affiliation: Department of Neurology, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Mark M
authors.initials: MM
authors.lastname: McDonald
authors.affiliation: Department of Neurology, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Jeremy S
authors.initials: JS
authors.lastname: Wetzel
authors.affiliation: Department of Neurology, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Jorge
authors.initials: J
authors.lastname: Kawano-Castillo
authors.affiliation: Department of Neurology, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Parker
authors.affiliation: Department of Neurology, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Joancy
authors.initials: J
authors.lastname: Archeval-Lao
authors.affiliation: Department of Neurology, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Chunyan
authors.initials: C
authors.lastname: Cai
authors.affiliation: Department of Neurology, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Mohammad H
authors.initials: MH
authors.lastname: Rahbar
authors.affiliation: Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Andy N D
authors.initials: AN
authors.lastname: Nguyen
authors.affiliation: Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Samer J
authors.initials: SJ
authors.lastname: Baba
authors.affiliation: Department of Neurology, The University of Texas Health Science Center at Houston, Houston, TX, USA james.c.grotta@uth.tmc.edu.
authors.forename: James C
authors.initials: JC
authors.lastname: Grotta
mesh_terms: D000368:Aged; D001777:Blood Coagulation; D001792:Blood Platelets / Q000473:pathology*; D016001:Confidence Intervals; D003710:Demography; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D020521:Stroke / Q000097:blood*; D013916:Thrombelastography / Q000379:methods*