The effect of antiplatelet therapy on the incidence of carotid plaque hemorrhage.

Hemorrhage into the carotid atheroma has recently been gaining attention with respect to the pathophysiology of cerebrovascular disease. Many patients are currently receiving platelet agents for various vascular diseases. Some researchers have postulated that antiplatelet therapy may be detrimental by possibly inducing intraplaque hemorrhage or by increasing preexisting hemorrhage. This retrospective study was undertaken to determine if the use of antiplatelet therapy increases the incidence of carotid plaque hemorrhage. Ninety-five consecutive carotid endarterectomies were performed and the atheromas examined microscopically for intraplaque hemorrhage. The atheromas were divided into two groups; those from patients receiving preoperative antiplatelet therapy and those who were not. Forty-five atheromas were removed from patients receiving preoperative antiplatelet therapy; 39 (87%) of these demonstrated intraplaque hemorrhage. Of the 50 atheromas which were removed from patients not receiving preoperative therapy, 45 (90%) showed intraplaque hemorrhage. We conclude that antiplatelet therapy does not increase the incidence of carotid plaque hemorrhage.