6/29/23, 1:37 AM PATCH Pathway Feedback Search Clinical Topics Home Studies PATCH PATCH DiseaseIntracerebral hemorrhage Trial question What is the role of platelet transfusion after acute spontaneous primary intracerebral hemorrhage in people taking antiplatelet therapy? Study design Multi-center Open label RCT Population Characteristics of study participants 41.0% female N = 190 59.0% male 190 patients (78 female, 112 male) Inclusion criteria: adult patients with supratentorial intracerebral hemorrhage who had used antiplatelet therapy for the last 7 days and had a Glasgow Coma Scale score 8 Key exclusion criteria: blood on brain imaging suggestive of epidural or subdural hematoma, or an underlying aneurysm or AVM; planned surgical evacuation of intracerebral hemorrhage within 24 h of admission; previous adverse reaction to platelet transfusion; history of coagulopathy; known thrombocytopenia; lacking mental capacity by national legal standards before intracerebral hemorrhage; or if death appeared imminent; infratentorial or large intraventricular hematomas Interventions https://web.pathway.md/studies/recYoUUTvSKo7hwfz 1/2 6/29/23, 1:37 AM PATCH Pathway N=97 platelet transfusion (1-2 platelet concentrates depending on the type of antiplatelet therapy; COX inhibitor or ADP receptor inhibitor plus standard care) N=93 standard care (standard care alone) Primary outcome Death or functional dependence at 3 months 72.0 % 72 56 54.0 % 36.0 % Significant increase 18.0 % NNH = 6 0.0 % Platelet transfusion Standard care Significant increase in death or functional dependence at 3 months (72% vs. 56%; aOR 2.05, 95% CI 1.18 to 3.56) Secondary outcomes No significant difference in survival at 3 months (68% vs. 77%; OR 0.62, 95% CI 0.33 to 1.19) No significant difference in poor outcome with mRS score 3-6 at 3 months (89% vs. 82%; OR 1.75, 95% CI 0.77 to 3.97) No significant difference in intracerebral hemorrhage growth at 24 hours (2.01 mL vs. 1.16 mL; AD 0.85 mL, 95% CI -5.66 to 7.36) Safety outcomes Significant difference in serious adverse events (42% vs. 29%) and death during hospital stay (24% vs. 17%). Conclusion In adult patients with supratentorial intracerebral hemorrhage who had used antiplatelet therapy for the last 7 days and had a Glasgow Coma Scale score 8, platelet transfusion was inferior to standard care with respect to death or functional dependence at 3 months. Reference Baharoglu MI, Cordonnier C, Salman RA et al. 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 Jun 25;387(10038):2605-2613. Open reference URL https://web.pathway.md/studies/recYoUUTvSKo7hwfz 2/2