Lower coated-platelet levels are associated with early hemorrhagic transformation in patients with non-lacunar brain infarction.
BACKGROUND
Coated-platelets, representing a subset of platelets with procoagulant potential, are elevated in patients with non-lacunar ischemic stroke and decreased in patients with spontaneous intracerebral hemorrhage. However, within the non-lacunar patient population there are individuals with lower levels of coated-platelets, which raises the possibility that these individuals would be susceptible to early hemorrhagic transformation (HT) of ischemic stroke.


OBJECTIVE
Because extremes in coated-platelet potential may be associated with either thrombotic or hemorrhagic events, we undertook a pilot study to investigate whether there is an association between coated-platelet production and the presence of early HT in patients with non-lacunar ischemic stroke.


METHODS
Coated-platelet levels were determined in 115 consecutive eligible patients with a diagnosis of non-lacunar ischemic stroke. Early HT was determined on CT scan examination and confirmed by MRI studies. The distribution of coated-platelet levels was summarized using the median and interquartile range (25th-75th percentiles) and compared statistically between patients with and without early HT using the non-parametric Wilcoxon rank sum test.


RESULTS
The median coated-platelet level in all non-lacunar stroke patients was 38.0% (interquartile range 30.5-48.3%). Early HT was detected in 11 patients (9.6%), and these patients had significantly lower coated-platelet levels compared with those without early HT [median 25.1% (interquartile range 20.4-35.5%) vs. 39.2% (31.6-49.5%), P = 0.003].


CONCLUSIONS
Lower levels of coated-platelets are associated with the presence of early HT in patients with non-lacunar ischemic stroke.
Prodan
C I
CI
Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA. calin-prodan@ouhsc.edu
Stoner
J A
JA
Cowan
L D
LD
Dale
G L
GL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology*; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed