Higher mean platelet volume determined shortly after the symptom onset in acute ischemic stroke patients is associated with a larger infarct volume on CT brain scans and with worse clinical outcome.
OBJECTIVE
Mean platelet volume (MPV) determined shortly after the onset of acute ischemic stroke represents the pre-stroke values. Data on its relationship to stroke severity/outcome have been conflicting. We related MPV to infarct volume on CT brain scans and risk of death/dependence 7 days and 3 months post-stroke.


METHODS
MPV (within 30h since stroke onset), infarct volume (13-83h since stroke onset) and clinical outcomes were evaluated in 81 consecutive patients (32 men, age 52-91 years, 10 small artery occlusion, 10 large artery atherosclerosis, 29 cardioembolic, 32 multiple probable/possible etiology).


RESULTS
Higher MPV was independently associated with larger ln-infarct volume [estimate 0.259, 95% confidence interval (CI) 0.004-0.513, P=0.046], greater risk of death/dependence 7 days post-stroke [relative risk (RR)=1.077, 95% CI 1.005-1.115, P=0.036], and greater risk of death/dependence 3 months post-stroke (RR=1.077, 95% CI 1.001-1.158, P=0.048). Considered covariates: stroke etiology, CT scan timing, platelet count and other hematological parameters, demographic variables, history of cerebrovascular, cardiac or cardiovascular diseases, diabetes, serum chemistry, previous antiplatelet and statin use and treatments delivered after the index event.


CONCLUSIONS
Data support the view about MPV as a determinant of severity/outcome of the acute ischemic stroke.
Pikija
Slaven
S
Department of Neurology, County Hospital Varazdin, Varazdin, Croatia. spikija@gmail.com
Cvetko
Danijel
D
Hajduk
Martina
M
Trkulja
Vladimir
V
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000502:physiology*; D001921:Brain / Q000000981:diagnostic imaging*; D002545:Brain Ischemia / Q000097:blood* / Q000150:complications*; D002544:Cerebral Infarction / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D011379:Prognosis; D020521:Stroke / Q000097:blood* / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome