title: Coated-Platelet Levels Increase with Number of Injuries in Patients with Mild Traumatic Brain Injury.
abstract: Coated-platelets are procoagulant platelets that are elevated in stroke and are associated with stroke recurrence. In a previous study, prompted by data showing an increased risk for stroke following traumatic brain injury (TBI), we found that coated-platelet levels are elevated in patients with combat-related mild TBI (mTBI) several years after the injury, compared with controls. We now investigate in an expanded patient population whether parameters commonly recorded in mTBI are related to increased coated-platelet potential. Coated-platelet levels were assayed in 120 mTBI patients at intervals ranging from 6 months to 10 years from the last injury. Correlations were calculated between coated-platelet levels and age, gender, race/ethnicity, loss of consciousness, alteration in consciousness, post-traumatic amnesia, number of injuries, mechanism of injury, time since first and last injury, smoking, medications that may influence coated-platelet levels, and pertinent comorbid conditions. Significant correlations were detected between coated-platelet levels and number of injuries (p = 0.026), gender (p = 0.01), and time since last injury (p = 0.04). A multi-variable linear model analysis, including these three parameters and an additional three parameters (race/ethnicity, smoking, and mechanism of injury) that reached a p value of <0.2, showed that the number of injuries were predictive of coated-platelet levels (p = 0.004). These results support a mechanistic link between increased coated-platelet levels and repeated injuries in mTBI. Long-term studies will be required to determine the impact of increased prothrombotic potential in mTBI patients.
authors.affiliation: 1 Veterans Administration Medical Center and Department of Neurology, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma.
authors.forename: Calin I
authors.initials: CI
authors.lastname: Prodan
authors.affiliation: 2 Cognitive Science Research Center, University of Oklahoma , Norman, Oklahoma.
authors.forename: Andrea S
authors.initials: AS
authors.lastname: Vincent
authors.affiliation: 3 Department of Medicine, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma.
authors.forename: George L
authors.initials: GL
authors.lastname: Dale
mesh_terms: D000328:Adult; D001792:Blood Platelets / Q000378:metabolism* / Q000473:pathology; D001924:Brain Concussion / Q000097:blood* / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010976:Platelet Count / Q000639:trends; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000639:trends; D014728:Veterans
keywords: mild traumatic brain injury; platelets; stroke; thrombosis