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The changes in clot microstructure in patients with ischaemic stroke and the effects of therapeutic intervention: a prospective observational study

Overview of attention for article published in BMC Neurology, March 2015
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Title
The changes in clot microstructure in patients with ischaemic stroke and the effects of therapeutic intervention: a prospective observational study
Published in
BMC Neurology, March 2015
DOI 10.1186/s12883-015-0289-1
Pubmed ID
Authors

Sophia N Stanford, Ahmed Sabra, Lindsay D’Silva, Matthew Lawrence, Roger HK Morris, Sharon Storton, Martyn Rowan Brown, Vanessa Evans, Karl Hawkins, Phylip Rhodri Williams, Simon J Davidson, Mushtaq Wani, John F Potter, Phillip A Evans

Abstract

Stroke is the second largest cause of death worldwide. Hypercoagulability is a key feature in ischaemic stroke due to the development of an abnormally dense clot structure but techniques assessing the mechanics and quality of clot microstructure have limited clinical use. We have previously validated a new haemorheological technique using three parameters to reflect clot microstructure (Fractal Dimension (d f )) ex-vivo, real-time clot formation time (T GP ) and blood clot strength (elasticity at the gel point (G'GP)). We aimed to evaluate these novel clotting biomarkers in ischaemic stroke and changes of clot structure following therapeutic intervention. In a prospective cohort study clot microstructure was compared in ischaemic stroke patients and a control group of healthy volunteers. Further assessment took place at 2-4 hours and at 24 hours after therapeutic intervention in the stroke group to assess the effects of thrombolysis and anti-platelet therapy. 75 patients (mean age 72.8 years [SD 13.1]; 47 male, 28 female) with ischaemic stroke were recruited. Of the 75 patients, 32 were thrombolysed with t-PA and 43 were loaded with 300 mg aspirin. The following parameters were significantly different between patients with stroke and the 74 healthy subjects: d f (1.760 ± .053 versus 1.735 ± 0.048, p = 0.003), TGP (208 ± 67 versus 231 ± 75, p = 0.05), G'GP (0.056 ± 0.017 versus 0.045 ± 0.014, p < 0.0001) and fibrinogen (3.7 ± 0.8 versus 3.2 ± 0.5, p < 0.00001). There was a significant decrease in d f (p = 0.02), G'GP (p = 0.01) and fibrinogen (p = 0.01) following the administration of aspirin and for d f (p = 0.003) and fibrinogen (p < 0.001) following thrombolysis as compared to baseline values. Patients with ischaemic stroke have denser and stronger clot structure as detected by d f and G'GP. The effect of thrombolysis on clot microstructure (d f ) was more prominent than antiplatelet therapy. Further work is needed to assess the clinical and therapeutic implications of these novel biomarkers.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 76 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United Kingdom 1 1%
Unknown 75 99%

Demographic breakdown

Readers by professional status Count As %
Researcher 13 17%
Student > Ph. D. Student 12 16%
Student > Master 8 11%
Student > Postgraduate 4 5%
Student > Doctoral Student 4 5%
Other 11 14%
Unknown 24 32%
Readers by discipline Count As %
Medicine and Dentistry 16 21%
Engineering 9 12%
Agricultural and Biological Sciences 4 5%
Neuroscience 4 5%
Biochemistry, Genetics and Molecular Biology 3 4%
Other 13 17%
Unknown 27 36%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 March 2015.
All research outputs
#15,327,280
of 22,796,179 outputs
Outputs from BMC Neurology
#1,482
of 2,433 outputs
Outputs of similar age
#155,959
of 261,551 outputs
Outputs of similar age from BMC Neurology
#29
of 45 outputs
Altmetric has tracked 22,796,179 research outputs across all sources so far. This one is in the 22nd percentile – i.e., 22% of other outputs scored the same or lower than it.
So far Altmetric has tracked 2,433 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.7. This one is in the 26th percentile – i.e., 26% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 261,551 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 31st percentile – i.e., 31% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 45 others from the same source and published within six weeks on either side of this one. This one is in the 24th percentile – i.e., 24% of its contemporaries scored the same or lower than it.