Association of Mean Platelet Volume with Risk Factors and Functional Outcome in Acute Ischemic Stroke

Abstract Background Stroke is the second leading cause of death in the world and a major cause of disability, with ischemic stroke contributing to 87% of all strokes. Platelets are central in the formation of thrombus, and in the process, they enlarge in size, become active, and secrete prothrombotic factors. This is supported by the presence of large platelets in ischemic stroke, where they may be implicated in the pathogenesis of vessel occlusion, leading to stroke. The mean platelet volume (MPV) is an important laboratory marker of platelet function and activation. Materials and Methods The present study was conducted to assess the role of MPV in the pathogenesis, severity, and outcome of ischemic stroke. It was an observational study in 100 acute ischemic stroke (AIS) patients (excluding cardioembolic stroke) admitted to the Medicine wards, Department of Medicine, Jawaharlal Nehru Medical College, a tertiary care hospital at Aligarh. The MPV was correlated with the conventional risk factors of ischemic stroke and outcome (using modified Rankin scale [mRS]). The study revealed statistically significant correlation between MPV and hypertension, type 2 diabetes mellitus, and carotid intima media thickness (CIMT). Also, the MPV at presentation positively correlated with mRS (correlation coefficient 0.818); thus, high MPV was associated with more severe disability. Conclusion The MPV at the time of presentation of ischemic stroke may be useful in predicting the severity of stroke and neurological recovery. However, a larger study including diverse population is required to endorse its predictive value in AIS.

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STUDY OF CAROTID INTIMA MEDIA THICKNESS IN PATIENTS WITH ACUTE ISCHEMIC STROKE AND ITS CORRELATION WITH RISK FACTORS OF ISCHEMIC STROKE - A CASE CONTROL STUDY

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/1476 ◽

2013 ◽

Vol 2 (44) ◽

pp. 8444-8454

Author(s):

Rajeev H ◽

Krishnappa Krishnappa ◽

Savitha V

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Case Control Study ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Case Control ◽

Media Thickness ◽

Control Study

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STUDY OF MEAN PLATELET VOLUME IN ISCHEMIC STROKE

10.36106/ijsr/9501930 ◽

2021 ◽

pp. 51-52

Author(s):

Pawan Kumar ◽

Khushboo Agarwal ◽

Ravi Kumar Bansal

Keyword(s):

Ischemic Stroke ◽

Mean Platelet Volume ◽

Tertiary Care ◽

Cost Effective ◽

Cross Sectional Study ◽

Care Hospital ◽

Platelet Volume ◽

Cross Sectional ◽

Severe Stroke ◽

Medical College

Background: Mean platelet volume, as well as platelet count, are an index of haemostasis and its dysfunction i.e. thrombosis. Aim of this study is to investigate the association between mean platelet volume (MPV) & acute ischemic stroke. Methods: This retrospective cross-sectional study included 200 patients admitted to the emergency & general opd (medicine & pediatric) of a tertiary care hospital in JLN Medical College Ajmer from Aug jan 2020 to Nov 2020. The data were evaluated according to MPV levels, National Institutes of Health Stroke Scale (NIHSS) scores. The patients were divided into groups based on MPV level ≤7.5, 7.6-10.0,10.1-12.5,≥12.6. Results: In our study, a signicant association was found between severity of stroke (according to NIHSS criteria) and MPV in male and female populations (p<0.0001 and p<0.0001 respectively). A signicant difference was found between MPV values of all 3 categories ie patients of severe stroke had higher value of MPV than those of mild and moderate stroke and patients of moderate stroke had higher values than those of mild stroke. Conclusion: This is a simple and cost effective test which can be easily done at any primary care centre and can serve as a useful marker to differentiate ischemic stroke from hemorrhagic stroke.

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Seroprevalence ofChlamydia PneumoniaeAntibodies in Stroke in Young

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100008337 ◽

2009 ◽

Vol 36 (6) ◽

pp. 725-730 ◽

Cited By ~ 9

Author(s):

V. C. S. Srinivasarao Bandaru ◽

D. Babu Boddu ◽

V. Laxmi ◽

M. Neeraja ◽

S. Kaul

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Magnetic Resonance ◽

Acute Ischemic Stroke ◽

Tertiary Care ◽

Control Group ◽

Care Hospital ◽

Igg Antibodies ◽

Stroke Patients ◽

Stroke In Young

Background:Younger patients, aged below 45 years, usually lack the conventional risk factors of stroke whereas infections, especially in developing countries, may play a role. There have been many reports in the last decade about the association ofChlamydia pneumoniae(C.pneumoniae) and atherosclerosis involving cerebral vessels.Objective:To investigate the seroprevalence ofC.pneumoniaeIgG and IgA antibodies in patients aged below 45 years with acute ischemic stroke.Methods:This study was done at a tertiary care hospital in South India between January 2004 and December 2006 where we recruited consecutive patients aged less than 45years with acute ischemic stroke. Age and sex matched controls were recruited from the outpatient department with non stroke diagnosis. All stroke patients underwent CT (Computerized Tomography), MRI (Magnetic Resonance Image), MRA (Magnetic Resonance Angiography), Transthoracic Echocardiography and Carotid Doppler for stroke sub group diagnosis. We measuredC.pneumoniaeantibodies IgG and IgA by microimmunofluorescence technique in all patients and controls.Results:A total of 120 patients and 120 controls were studied over a period of two years. We foundC.pneumoniaeantibodies in 29.1% (35/120) stroke patients and in 12.5% (15/120) control subjects (p=0.002).C.pneumoniaeIgG antibodies were found in 27.5 % (33/120) of stroke patients and 12.5% (15/120) of controls (p=0.006). IgAantibodies were observed in 5 % (6/120) of strokes and none in control group (p=0.03). After adjustment of all risk factorsC.pneumoniaeIgG seropositivity showed odds ratio of 2.6; 95% Confidence Interval 1.2-5.6.Conclusions:C.pneumoniaeIgG antibodies were found to be associated with ischemic stroke in young.

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Importance of Carotid Intima Media Thickness in Ischemic Stroke in a Tertiary Care Hospital

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v6i8.135 ◽

2018 ◽

Vol 6 (8) ◽

Author(s):

Dr Sachin Bongale ◽

Keyword(s):

Ischemic Stroke ◽

Tertiary Care Hospital ◽

Tertiary Care ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Care Hospital ◽

Media Thickness

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An observational study from a new tertiary care hospital in North Odisha: clinical and etiological profile of acute ischemic stroke patients

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20194227 ◽

2019 ◽

Vol 6 (5) ◽

pp. 1605

Author(s):

Bibhu P. Behera ◽

Partha S. Mohanty

Keyword(s):

Risk Factors ◽

Ischemic Stroke ◽

Observational Study ◽

Acute Ischemic Stroke ◽

Hemorrhagic Stroke ◽

Tertiary Care ◽

Care Hospital ◽

Stroke Patients ◽

Middle Income ◽

Stroke Subtypes

Background: Worldwide, cerebrovascular accidents (stroke) are the second leading cause of death and the third leading cause of disability. According to WHO estimation, by 2050 nearly 80% of stroke cases may occur in low and middle-income countries like China and India. It is critical that we understand the etiology causing the stroke so that appropriate treatment can be initiated in a timely fashion. Furthermore, understanding the risk factors associated with stroke is important before primary and secondary preventive measures can be prescribed to the patient.Methods: This observational study was carried out amongst 481 acute ischemic stroke patients that fulfils the inclusion and exclusion criteria and admitted in medicine ward of Pandit Raghunath Murmu Medical College and Hospital, Baripada, Dist. Mayurbhanj, Odisha, India from June 2018 to January 2019. Results: In our study, 481(60.43%) patients had ischemic stroke and 315 (39.57%) patients had hemorrhagic stroke. The incidence of stroke is maximum in 51-70 years of age group which comprises of 59.46% of total patients. The average age + SD were 61.4±13.1 in our study. The most common risk factor was hypertension with 69.85% followed by dyslipidemia 51.77%. Most common clinical presentation was hemiplegia (72.35%) followed by speech involvement (59.46%). Most common site of infarct was parietal (22.25%), followed by periventricular (12.68%).Conclusions: Most of the patients had ischemic stroke as compared to hemorrhagic stroke. It was more common in males. The study contributes to understanding of demographic characteristics, risk factors, and stroke subtypes in acute ischemic stroke. The importance of various risk factors among ischemic stroke subtypes should be stressed for prompt preventive strategies and treatment.

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Abstract TP202: Association of Rs7961894 with Mean Platelet Volume in Patients with Acute Ischemic Stroke

Stroke ◽

10.1161/str.48.suppl_1.tp202 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Malgorzata Miller ◽

Nils Henninger ◽

Renato Umeton ◽

Agnieszka Slowik

Keyword(s):

Ischemic Stroke ◽

Acute Ischemic Stroke ◽

Mean Platelet Volume ◽

Myocardial Infarct ◽

Mortality Data ◽

Platelet Volume ◽

Laboratory Findings ◽

Stroke Subtypes ◽

Increased Risk ◽

One Year

Introduction: Mean platelet volume (MPV) is a marker of platelet function and elevated MPV was found to be an independent risk factor for death after myocardial infarct in patients with coronary artery disease. Higher MPV was associated with increased risk of ischemic stroke, yet there is insufficient data regarding the role of MPV as a marker of outcome in patients with ischemic stroke. The variability of platelet indices in humans is largely determined by genetic factors and rs7961894 located within intron 3 of WDR66 gene showed the strongest association with MPV in all genome wide association (GWA) studies in the European population. Aim: To determine the association of rs7961894 with MPV in patients with acute ischemic stroke and to assess whether rs7961894 and MPV could be markers of one year mortality in different stroke subtypes. Material and methods: For 426 adults with first-ever ischemic stroke MPV was measured within 72h of stroke onset and single nucleotide polymorphism genotyping of rs7961894 was performed accordingly (RT-PCR, Applied Biosystems). Epidemiologic and clinical characteristics (including TOAST classification), laboratory findings as well as one year mortality data were collected for each participant. Results: Allele T and genotypes CT and TT of the rs7961894 polymorphism were associated with the highest (>11.5fL) MPV quartile (Chi 2 test, p<0.01). MPV was significantly higher in patients with genotype TT as compared to CT and CC genotype (12.0±0.24fL vs. 11.10±0.15fL and 10.77±0.05fL, respectively, ANOVA, p <0.005 with Tukey HSD post-hoc test, Figure 1). Conclusions: Allele T of rs7961894 polymorphism is associated with increased MPV in the recessive and dominant model and patients with genotype TT have significantly higher MPV as compared to the rest of the population study. Further analysis is currently being conducted to determine the association of MPV and rs7961894 polymorphism with one year mortality and stroke subtypes.

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Carotid Intima Media Thickness in Graves Disease: Comparing Overt Hyperthyroid and Remission State

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.578 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A284-A285

Author(s):

Intan Nurjannah ◽

Wismandari Wisnu ◽

Dicky L Tahapary ◽

Ika Prasetya Wijaya

Keyword(s):

Risk Factors ◽

Clinical Signs ◽

Signs And Symptoms ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Graves Disease ◽

Care Hospital ◽

Media Thickness ◽

Clinical Signs And Symptoms ◽

Overt Hyperthyroidism

Abstract Background/Objective: Hyperthyroid has been associated with increased cardiovascular event. Carotidintima media thickness (CIMT) is oftenly measured to evaluate the risk of cardiovascularevent. The aim of this study is to measure CIMT in Graves’ disease and to comparebetween subjects in overt hyperthyroidism and remission state. Methods: Our study was a cross-sectional study performed at the outpatient endocrinologyclinic of Dr. Cipto Mangunkusumo Hospital, a tertiary care hospital in Jakarta, Indonesia. Graves’ disease subjects were recruited, of whom then grouped into overthyperthyroidism (clinical signs and symptoms of hyperthyroidism, low THS, highthyroxine levels, treatment naïve of within 3 months of treatments) and remission state(no clinical signs and symptoms of hyperthyroidism, normal THs and thyroxine levels,without any anti thyroid drugs for at least 6 months). CIMT measurements wereperformed by trained physician on both right and left artery carotid arteries using anultrasound equipped with software that automatically measured the CIMT. We alsomeasured lipid profile, fasting blood glucose, and ECG. Results: We recruited 49 Graves’ disease subjects, of whom 32 and 17 subjects werein overt hyperthyroidism and remission state respectively. Median CIMT in overthyperthyroidism and remission state were 0,473 mm and 0,488 mm respectively, p:0,109. Among clinical and laboratory risk factors, only age which had an independentcorrelation with CIMT in Graves disease. (r: 0,371; p:<0,0001). Discussion: Our is the first study that measured CIMT among subjects with Graves’disease in remission and overt hyperthyroidism state, of which we observed nodifferences. This might be due to the fact that the atherosclerosis risk factors were notdistributed evenly on both group, of which subjects were older in the remission group. Ithas been reported that there are increasing CIMT along with aging (0,003-0,010 mm peryear). Furthermore, in remission state we need to take metabolic and physical changesinto consideration, such as increasing weight as much as 2,5% from prior weight alongwith increasing total cholesterol and LDL-cholesterol which both can affect CIMT levels. Conclusions: There are no significant differences in CIMT between overt hyperthyroid andremission state in Graves’ disease. Keywords: carotid intima media thickness, Graves’ disease, overt hyperthyroid, remission.

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Abstract WP1: Thrombectomy Outcomes in Acute Ischemic Stroke due to Middle Cerebral Artery M2 Occlusion with Stent-Retriever, Aspiration, MERCI: Multi-Center Experience

Stroke ◽

10.1161/str.48.suppl_1.wp1 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Kunakorn Atchaneeyasakul ◽

Amer M Malik ◽

Dileep R Yavagal ◽

Mehdi Bouslama ◽

Diogo C Haussen ◽

...

Keyword(s):

Ischemic Stroke ◽

Middle Cerebral Artery ◽

Acute Ischemic Stroke ◽

Cerebral Artery ◽

Tertiary Care ◽

Stent Retriever ◽

Anterior Circulation ◽

Vessel Occlusion ◽

Symptomatic Intracerebral Hemorrhage ◽

Significant Difference

Introduction: Recent trials demonstrated that mechanical thrombectomy improve functional outcome in anterior circulation acute ischemic stroke (AIS) due to emergent large vessel occlusion (ELVO) of the middle cerebral artery (MCA) M1 segment. However, such data regarding AIS due to MCA M2 segment ELVO is limited. Analysis of the STAR, SWIFT, and SWIFT-PRIME trials found thrombectomy in MCA M2 occlusion to be feasible in achieving successful reperfusion. The most optimal technique and/or device used for such reperfusion is not clearly defined. We aim to compare the outcome for the contemporary techniques and devices used for thrombectomy of AIS patients due to MCA M2 ELVO. Methods: A retrospective review of AIS patients with MCA M2 ELVO receiving thrombectomy from three tertiary care academic medical centers was conducted. Thrombectomy technique and thrombectomy device utilized were recorded. Outcomes were successful angiographic reperfusion (TICI ≥2b), favorable modified Rankin Scale (mRS≤2) at discharge and at 90 days, and rate of symptomatic intracerebral hemorrhage (sICH). Results: From October 1999 through June 2016, 253 AIS patients underwent thrombectomy for MCA M2 ELVO. Thrombectomy methods utilized were Stent-retriever (n=118), Aspiration only [manual or Penumbra device] (n=83), and MERCI retriever (n=52). Table 1 shows rate of outcomes measured. There was no difference in baseline NIHSS or in stroke onset to groin puncture time. Stent-retriever group showed a significantly higher recanalization rate, lower sICH rate, and favorable 90-day mRS versus Aspiration group or MERCI group, respectively. No significant difference was seen in discharge mRS between the groups. Conclusions: Thrombectomy for AIS patients with MCA M2 ELVO with Stent-retriever appears to be feasible with a significantly higher rate of recanalization, lower sICH rate, and favorable 90-day mRS when compared to Aspiration and MERCI.

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