title: Higher coated-platelet levels are associated with stroke recurrence following nonlacunar brain infarction.
abstract: Coated-platelets are procoagulant platelets observed upon dual-agonist stimulation with collagen and thrombin. Coated-platelet levels are elevated in patients with nonlacunar (large-vessel) ischemic stroke and decreased in patients with spontaneous intracerebral hemorrhage as compared with controls. The purpose of this study was to investigate a possible relationship between coated-platelet levels and stroke recurrence in patients with nonlacunar ischemic stroke. We assayed coated-platelet levels in 190 consecutive patients with nonlacunar stroke who were followed for up to 12 months; 20 subjects experienced recurrent stroke. Subjects were categorized into tertiles of coated-platelet levels. The distributions of time-to-recurrent stroke were estimated for each tertile using cumulative incidence curves and compared statistically using a log-rank test. The cumulative incidence of recurrent stroke at 12 months differed among the coated-platelet tertiles: 2% for the first tertile (lowest coated-platelet levels), 18% for the second tertile, and 17% for the third tertile (overall log-rank test, P=0.019). These data suggest that higher levels of coated-platelets, measured shortly after a nonlacunar stroke, are associated with an increased incidence of stroke recurrence. This observation offers an additional tool for identifying patients at highest risk for stroke recurrence following a nonlacunar (large-vessel) infarct.
authors.affiliation: Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA. calin-prodan@ouhsc.edu
authors.forename: Calin I
authors.initials: CI
authors.lastname: Prodan
authors.forename: Julie A
authors.initials: JA
authors.lastname: Stoner
authors.forename: Linda D
authors.initials: LD
authors.lastname: Cowan
authors.forename: George L
authors.initials: GL
authors.lastname: Dale
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000378:metabolism* / Q000473:pathology; D020520:Brain Infarction / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D003094:Collagen / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010979:Platelet Function Tests; D020521:Stroke / Q000097:blood* / Q000453:epidemiology / Q000209:etiology; D013917:Thrombin / Q000378:metabolism
chemical_list: D003094:Collagen; D013917:Thrombin