Levels and value of platelet activation markers in different subtypes of acute non-cardio-embolic ischemic stroke.
BACKGROUND
Platelet activation and its interaction with leukocytes are important in the pathophysiology of ischemic stroke. This study aimed to evaluate the value of platelet activation and platelet-leukocyte interaction in different subtypes of acute, non-cardio-embolic ischemic stroke.


METHODS
Fifty-four patients with acute, non-cardio-embolic ischemic stroke, including 32 small-vessel and 22 large-vessel diseases, were evaluated. Platelet activation markers (CD62P, CD63, and CD40L) and platelet-leukocyte interaction were measured by flow cytometry at different time points (<48 hours and Days 7, 30, and 90 post-ischemic stroke). Markers were also evaluated in 28 other stroke patients in the convalescent stage (3 to 9 months after acute stroke) and in 28 control subjects.


RESULTS
Patients with ischemic stroke had significantly increased circulating CD62P, CD63, platelet-monocyte interaction, and platelet-lymphocyte interaction in the acute stage compared with the convalescent stage and control groups. Levels of CD62P and CD63 were significantly higher in the large-vessel disease group than in the small-vessel disease group, and differences in CD62P were significant even at one month. The CD40L level in the poor outcome group was significantly higher than that in the good outcome group. Stroke patients with diabetes mellitus and large-vessel disease were associated with poor outcome.


CONCLUSIONS
Patients with large-vessel cerebral infarction elicit higher platelet activation and platelet-leukocyte interaction compared to small-vessel infarction. Further large scale trials are warranted to evaluate the relationship between platelet activation markers and outcome in stroke patients under different anti-platelet therapies, and to clarify optimal treatment.
Tsai
Nai-Wen
NW
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Chang
Wen-Neng
WN
Shaw
Chen-Fu
CF
Jan
Chung-Ren
CR
Chang
Hsueh-Wen
HW
Huang
Chi-Ren
CR
Chen
Shang-Der
SD
Chuang
Yao-Chung
YC
Lee
Lian-Hui
LH
Wang
Hung-Chen
HC
Lee
Tsong-Hai
TH
Lu
Cheng-Hsien
CH
D000208:Acute Disease; D000368:Aged; D000906:Antibodies / Q000378:metabolism; D015703:Antigens, CD / Q000097:blood / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D001792:Blood Platelets / Q000378:metabolism*; D002545:Brain Ischemia / Q000150:complications / Q000378:metabolism*; D016022:Case-Control Studies; D005260:Female; D016650:Fluorescein-5-isothiocyanate / Q000378:metabolism; D005456:Fluorescent Dyes / Q000378:metabolism; D006801:Humans; D017493:Leukocyte Common Antigens / Q000378:metabolism; D007962:Leukocytes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood / Q000378:metabolism; D010799:Phycoerythrin / Q000378:metabolism; D015539:Platelet Activation / Q000502:physiology*; D010979:Platelet Function Tests; D010980:Platelet Membrane Glycoproteins / Q000378:metabolism; D020521:Stroke / Q000150:complications / Q000378:metabolism*
D000906:Antibodies; D015703:Antigens, CD; D015415:Biomarkers; D005456:Fluorescent Dyes; D019007:P-Selectin; D010980:Platelet Membrane Glycoproteins; D010799:Phycoerythrin; D017493:Leukocyte Common Antigens; D016650:Fluorescein-5-isothiocyanate