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Open AccessArticle

Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke

1
Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg 5020, Austria
2
Department of Neurology, Univerzitetni Klinični Center, Maribor 2000, Slovenia
3
Department of Anesthesiology, General Hospital Varazdin, Varazdin 42000, Croatia
4
Department of Cardiac Surgery, Salzburger Landeskliniken, Paracelsus Medical University, Salzburg 5020, Austria
5
Division of Neuroradiology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg 5020, Austria
6
Department of Neurology, Klinikum rechts der Isar, Technische Universität München, München 81675, Germany
*
Author to whom correspondence should be addressed.
Academic Editor: Shaker A. Mousa
Int. J. Mol. Sci. 2016, 17(9), 1382; https://doi.org/10.3390/ijms17091382
Received: 24 July 2016 / Revised: 16 August 2016 / Accepted: 18 August 2016 / Published: 23 August 2016
(This article belongs to the Special Issue Vascular Biology and Therapeutics)
We explored whether clot density in middle cerebral artery (MCA) occlusion is related to clinical variables, stroke etiology, blood constituents, and prestroke medication. We performed a retrospective chart review of patients with acute ischemic stroke of the anterior circulation admitted to two Central European stroke centers. The acquisition of non-contrast enhanced CT (NECT) and CT angiography (CTA) within 4.5 h of symptom onset was obligatory. We assessed the site of MCA occlusion as well as density, area, and length of the clot in 150 patients. The Hounsfield unit values for the clot were divided with contralateral MCA segment to yield relative Hounsfield Unit ratio (rHU). The site of the vessel occlusion (M1 vs. M2) and antiplatelet usage, but not stroke etiology, significantly influenced rHU. We found an inverse correlation of rHU with erythrocyte count (p < 0.001). The multivariate analysis revealed that a higher rHU (i.e., clot being more hyperdense) was more likely with the use of antiplatelets (OR 4.24, CI 1.10–16.31, p = 0.036). Erythrocyte (OR 0.18, CI 0.05–0.55, p = 0.003), and thrombocyte counts (OR 0.99, CI 0.98–0.99, p = 0.029) were associated with odds for more hypodense clots (lower rHU). Our study disclosed that antiplatelet therapy impacts the composition of intracranial clots of the anterior circulation. View Full-Text
Keywords: ischemic stroke; hyperdense artery sign; antiplatelets; computed tomography; clot ischemic stroke; hyperdense artery sign; antiplatelets; computed tomography; clot
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MDPI and ACS Style

Pikija, S.; Magdic, J.; Lukic, A.; Schreiber, C.; Mutzenbach, J.S.; McCoy, M.R.; Sellner, J. Antiplatelet Usage Impacts Clot Density in Acute Anterior Circulation Ischemic Stroke. Int. J. Mol. Sci. 2016, 17, 1382.

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