BMJ Open (Apr 2022)

Platelet transmission electron microscopy for the assessment of poor biological response to antiplatelet agent: pilot descriptive and prospective study - ELECTROSTROKE

  • Patrick Mismetti,
  • Arnauld Garcin,
  • Guorong Li,
  • Pierre Garnier,
  • Nora Mallouk,
  • Magali Epinat,
  • Claire Szczepaniak,
  • Ollo Franck Hien

DOI
https://doi.org/10.1136/bmjopen-2021-050060
Journal volume & issue
Vol. 12, no. 4

Abstract

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Introduction Ischaemic stroke is the leading cause of adult disability. Thus, a strategy based on an efficient antiplatelet therapy has been developed. The monitoring of antiplatelet therapy is now limited to high risk and poor prognosis patients. Indeed, the biological monitoring of the antiplatelet therapy with available platelet function assays do not provide a global integrative approach. Platelet transmission electron microscopy, recently validated for assessing distinct ultrastructural abnormalities is a reliable morphological platelet structural analysis tool which could be used to collect all the ultrastructural platelet characteristics and assess the degree of activation of platelets.Methods and analysis Our pilot prospective and descriptive study will include 50 consecutive patients hospitalized for an ischaemic stroke. We expect to identify ultrastructural characteristics that will be correlated with the degree of platelet activation to guide clinicians in decision making regarding the antiplatelet therapy strategy.Ethics and dissemination The French Ethics Committee (comité de protection des personnes d’Ile-de-France VII) approved the information notice that will be given to participants and the protocol of this trial (protocol No 21-031).The results of the trial will be disseminated through scientific publications.Trial registration number NCT05004233.