title: Thrombogenic microvesicles and white matter hyperintensities in postmenopausal women.
abstract: OBJECTIVE
  To determine the association of conventional cardiovascular risk factors, markers of platelet activation, and thrombogenic blood-borne microvesicles with white matter hyperintensity (WMH) load and progression in recently menopausal women.
  
  
  METHODS
  Women (n = 95) enrolled in the Mayo Clinic Kronos Early Estrogen Prevention Study underwent MRI at baseline and at 18, 36, and 48 months after randomization to hormone treatments. Conventional cardiovascular risk factors, carotid intima-medial thickness, coronary arterial calcification, plasma lipids, markers of platelet activation, and thrombogenic microvesicles were measured at baseline. WMH volumes were calculated using a semiautomated segmentation algorithm based on fluid-attenuated inversion recovery MRI. Correlations of those parameters with baseline WMH and longitudinal change in WMH were adjusted for age, months past menopause, and APOE ε4 status in linear regression analysis.
  
  
  RESULTS
  At baseline, WMH were present in all women. The WMH to white matter volume fraction at baseline was 0.88% (0.69%, 1.16%). WMH volume increased by 122.1 mm(3) (95% confidence interval: -164.3, 539.5) at 36 months (p = 0.003) and 155.4 mm(3) (95% confidence interval: -92.13, 599.4) at 48 months (p < 0.001). These increases correlated with numbers of platelet-derived and total thrombogenic microvesicles at baseline (p = 0.03).
  
  
  CONCLUSIONS
  Associations of platelet-derived, thrombogenic microvesicles at baseline and increases in WMH suggest that in vivo platelet activation may contribute to a cascade of events leading to development of WMH in recently menopausal women.
authors: Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN, USA.
authors: Limor
authors: L
authors: Raz
authors: M
authors: M
authors: Jayachandran
authors: Nirubol
authors: N
authors: Tosakulwong
authors: Timothy G
authors: TG
authors: Lesnick
authors: Samantha M
authors: SM
authors: Wille
authors: Matthew C
authors: MC
authors: Murphy
authors: Matthew L
authors: ML
authors: Senjem
authors: Jeffrey L
authors: JL
authors: Gunter
authors: Prashanthi
authors: P
authors: Vemuri
authors: Clifford R
authors: CR
authors: Jack
authors: Virginia M
authors: VM
authors: Miller
authors: Kejal
authors: K
authors: Kantarci
mesh_terms: D000328:Adult; D001792:Blood Platelets / Q000473:pathology*; D001921:Brain / Q000098:blood supply / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000473:pathology; D005260:Female; D006801:Humans; D020767:Intracranial Thrombosis / Q000473:pathology*; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D017698:Postmenopause; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors