Research in context
Systematic review
Before we initiated the PATCH trial in 2009, a search of ClinicalTrials.gov and the Cochrane Central Register of Controlled Trials (CENTRAL) did not reveal published, ongoing, or planned randomised trials of platelet transfusion for acute intracerebral haemorrhage in people taking antiplatelet therapy. On April 1, 2016, we searched MEDLINE (PubMed) from Jan 1, 1950, Embase from Jan 1, 1947; ClinicalTrials.gov, and CENTRAL from Jan 1, 1993, using textwords for platelet transfusion (“platelet” OR “blood platelet” OR “thrombocyte”) and the textword “transfusion” and terms for intracerebral haemorrhage and randomised trials, as well as bibliographies of relevant publications, for trials of platelet transfusion for acute intracerebral haemorrhage in people taking antiplatelet therapy, irrespective of language of publication. We found one ongoing randomised trial (NCT00699621) and one published randomised trial dissimilar to PATCH of platelet transfusion versus aspirin resumption for aspirin-sensitive people with acute basal ganglia intracerebral haemorrhage undergoing craniotomy.
Added value of this study
This is the only completed randomised trial of people taking antiplatelet therapy who have acute intracerebral haemorrhage to compare the effects of platelet transfusion with standard care on functional outcome. Platelet transfusion seemed inferior to standard care for reducing death or dependence after acute intracerebral haemorrhage in people taking antiplatelet therapy.
Interpretation of all the available evidence
Platelet transfusion seems inferior to standard care after acute intracerebral haemorrhage in people taking antiplatelet therapy. We cannot recommend platelet transfusion for this indication, pending the results of another similar randomised trial.