Link between platelet activity and outcomes after an ischemic stroke

Cerebrovasc Dis. 2005;20(2):120-8. doi: 10.1159/000086802. Epub 2005 Jul 5.

Abstract

Background: Platelets play an important role in atherosclerosis and thromboembolic events. We examined the relationship between platelet activity and outcomes after an ischemic stroke.

Methods: Using flow cytometry, we serially measured the fractions of circulating platelet activity (CD62p expression) after an ischemic stroke in early (<48 h), recent (day 7), convalescent (day 21) and chronic (day 90) phases in 92 consecutive patients with an ischemic stroke. Patients were classified into high (CD62p expression >3.16%) and low (CD62p expression < or =3.16%) platelet activity groups according to the median value of CD62p expression in the early phase of a stroke.

Results: The composite end point--death, recurrent stroke and severe neurological impairment (alive in care), defined as a score of >13 on the National Institutes of Health Stroke Scale--within the first 30 days and at an interval of 8.2 +/- 1.5 months of follow-up was determined for each group. In the first 30 days, the composite end point occurred in 37.0% of patients in the high platelet activity group as compared with 6.5% in the low platelet activity group (p = 0.0004). At a mean follow-up of 8.2 +/- 1.5 months, the composite end point occurred in 36.6% of patients in the high platelet activity group as compared with 10.9% in the low platelet activity group (p = 0.0044). Multiple stepwise logistic regression analysis displayed that high platelet activity (p = 0.011), age (p = 0.013) and the presence of coronary artery disease (p = 0.021) were independently associated with adverse outcomes at the intermediate-term follow-up.

Conclusions: Results of this study showed that high platelet activity is strongly associated with adverse clinical outcomes after an early ischemic stroke.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aspirin / therapeutic use
  • Blood Platelets / physiology*
  • Endpoint Determination
  • Female
  • Flow Cytometry
  • Humans
  • Logistic Models
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prospective Studies
  • Radiography
  • Recurrence
  • Risk Assessment
  • Stroke / blood*
  • Stroke / diagnostic imaging
  • Stroke / therapy*
  • Treatment Outcome

Substances

  • Platelet Aggregation Inhibitors
  • Aspirin