Stroke study prompts call for revised treatment guidelines
May 2016: The findings of a study co-led by Professor Rustam Al-Shahi Salman recommend a change in clinical guidelines for the treatment of people who suffer stroke due to intracerebral haemorrhage while taking aspirin.
The results of the PATCH (Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy), which are published in The Lancet today, recommend a change in guidelines for treating any patients who have had a stroke caused by bleeding into the brain – known as intracerebral haemorrhage (ICH) – while regularly taking aspirin.
Until now, platelet transfusion has been regularly used in the hope that it will aid recovery. It had been thought that platelets – blood cell fragments that play a vital role in blood clotting – could block ruptured blood vessels and prevent further bleeding into the brain.
However, a team co-led by Professor Rustam Al-Shahi Salman of CCBS has found that giving platelet transfusions to patients who had suffered an ICH while taking aspirin reduced their chances of recovery. The platelet transfusions increased the risk of death and long-term disability compared with usual care.
The researchers cannot fully explain why patients given platelet transfusions were worse off than those who were not. They suggest that the treatment may cause blood clots to form or trigger inflammation in the brain, worsening bleeding.
The study, carried out in collaboration with the Academic Medical Centre in Amsterdam and Lille University, was supported by Chest Heart and Stroke Scotland.
Our study shows that platelet transfusion seems harmful, and certainly is not beneficial, for people who take aspirin and have a stroke caused by bleeding into the brain. These findings should change clinical guidelines.
Stroke due to Haemorrhage
Each year, about two million adults worldwide suffer stroke caused by ICH, which accounts for half of all stroke deaths. Two out of five people die within one month, and a further two out of five become dependent on carers.
Out of the 10,000 cases of ICH in the UK each year, around one-quarter of patients are estimated to have been taking a course of aspirin beforehand.
Related Links
Research to Understand Stroke due to Haemmorhage (RUSH) programme
Professor Rustam Al-Shahi Salman Principal Investigator profile