Link between platelet activity and outcomes after an ischemic stroke.
BACKGROUND
Platelets play an important role in atherosclerosis and thromboembolic events. We examined the relationship between platelet activity and outcomes after an ischemic stroke.


METHODS
Using flow cytometry, we serially measured the fractions of circulating platelet activity (CD62p expression) after an ischemic stroke in early (<48 h), recent (day 7), convalescent (day 21) and chronic (day 90) phases in 92 consecutive patients with an ischemic stroke. Patients were classified into high (CD62p expression >3.16%) and low (CD62p expression < or =3.16%) platelet activity groups according to the median value of CD62p expression in the early phase of a stroke.


RESULTS
The composite end point--death, recurrent stroke and severe neurological impairment (alive in care), defined as a score of >13 on the National Institutes of Health Stroke Scale--within the first 30 days and at an interval of 8.2 +/- 1.5 months of follow-up was determined for each group. In the first 30 days, the composite end point occurred in 37.0% of patients in the high platelet activity group as compared with 6.5% in the low platelet activity group (p = 0.0004). At a mean follow-up of 8.2 +/- 1.5 months, the composite end point occurred in 36.6% of patients in the high platelet activity group as compared with 10.9% in the low platelet activity group (p = 0.0044). Multiple stepwise logistic regression analysis displayed that high platelet activity (p = 0.011), age (p = 0.013) and the presence of coronary artery disease (p = 0.021) were independently associated with adverse outcomes at the intermediate-term follow-up.


CONCLUSIONS
Results of this study showed that high platelet activity is strongly associated with adverse clinical outcomes after an early ischemic stroke.
Yip
Hon-Kan
HK
Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Niao Sung Hsiang, Kaohsiung Hsien, Taiwan, ROC.
Liou
Chia-Wei
CW
Chang
Hsueh-Wen
HW
Lan
Min-Yu
MY
Liu
Josef S
JS
Chen
Mien-Cheng
MC
D000368:Aged; D001241:Aspirin / Q000627:therapeutic use; D001792:Blood Platelets / Q000502:physiology*; D023381:Endpoint Determination; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011446:Prospective Studies; D011859:Radiography; D012008:Recurrence; D018570:Risk Assessment; D020521:Stroke / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy*; D016896:Treatment Outcome
D010975:Platelet Aggregation Inhibitors; D001241:Aspirin