Spontaneous intracerebral hemorrhages are often serious and may be fatal. Platelet transfusions are used to treat patients with hemorrhagic strokes associated with anti-platelet therapy. However, a new randomized, open-label, multi-center, phase 3 trial published in The Lancet surprisingly suggests that platelet transfusions may do more harm than good for these patients. Over 6 years, 97 patients were randomly assigned to receive platelet transfusions, and 93 received standard care. Patients receiving platelet transfusions had a higher odds of death at three months than those receiving standard care (adjusted odds ratio, 2.05 [95% CI, 1.18 – 3.56]; P=0.011); 23 patients (24%) in the platelet transfusion group died compared to 16 (17%) in the standard care group. Although this is a small, randomized trial, these data suggest that platelet transfusions should not be used to treat patients with intracerebral hemorrhagic stroke who were taking antiplatelet therapy.
References
- Baharoglu MI, Cordonnier C, Salman RA, de Gans K, Koopman MM, Brand A, Majoie CB, Beenen LF, Marquering HA, Vermeulen M, Nederkoorn PJ, de Haan RJ, Roos YB, Investigators P. Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial. Lancet 2016.
- Prodan CI. Platelets after intracerebral haemorrhage: more is not better. Lancet 2016.
