Coated–platelets in Ischemic Stroke

US Neurology ◽  
2010 ◽  
Vol 05 (02) ◽  
pp. 55
Author(s):  
Calin I Prodan ◽  
George L Dale ◽  
◽  
Keyword(s):  
Ischemic Stroke ◽  
Biochemical Marker ◽  
Platelet Reactivity ◽  
Lacunar Stroke ◽  
Stroke Patients ◽  
Stroke Subtypes ◽  
Cortical Stroke ◽  
Critical Components ◽  
First Time

While platelets are acknowledged as critical components of ischemic stroke pathophysiology, little is known about the role of platelet reactivity or platelet subclasses in stroke. Coated-platelets are a pro-thrombotic subclass of platelets, levels of which can vary substantially among individuals. Recently, coated-platelets were observed to be elevated in cortical stroke patients and decreased in lacunar stroke patients, thereby providing for the first time a biochemical marker distinguishing these two stroke subtypes. This article reviews the primary observation as well as the clinical and epidemiological implications of this finding.

Role of dyslipidemia in ischemic stroke patients treated in the telestroke network

2021 ◽  
Vol 66 (2) ◽  
pp. 254-261
Author(s):  
Leanne Brechtel ◽  
Nicolas Poupore ◽  
Margaret Monroe ◽  
Krista Knisley ◽  
Carolyn Sanders ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Stroke Patients

scholarly journals Role of Monitoring in Management of Acute Ischemic Stroke Patients

Stroke ◽  
2003 ◽  
Vol 34 (11) ◽  
pp. 2599-2603 ◽  
Author(s):  
Anna Cavallini ◽  
Giuseppe Micieli ◽  
Simona Marcheselli ◽  
Silvana Quaglini
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Stroke Patients

Abstract P670: Obesity and Mortality After the First Ischemic Stroke: Is Obesity Paradox Real?

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Durgesh Chaudhary ◽  
Ayesha Khan ◽  
Mudit Gupta ◽  
Yirui Hu ◽  
Jiang Li ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Proportional Hazards Model ◽  
Obesity Paradox ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Obese Patients ◽  
Stroke Patients ◽  
Stroke Event ◽  
One Year ◽  
First Time

Introduction: Obesity is an established risk factor for ischemic stroke but the association of increased body mass index (BMI) with survival after ischemic stroke remains controversial. Many studies have shown that increased BMI has a “protective” effect on survival after stroke while other studies have debunked the obesity paradox. This study aimed at examining the relationship between BMI and all-cause mortality at one year in first-time ischemic stroke patients using data extracted from different resources including electronic health records. Methods: We analyzed consecutive ischemic stroke patients captured in the Geisinger NeuroScience Ischemic Stroke (GNSIS) database. Survival in first-time ischemic stroke patients was analyzed using Kaplan-Meier estimator, stratified by different BMI categories. The predictors of mortality at one-year were assessed using a multivariate Cox proportional hazards model. Results: Among 6,703 first-time adult ischemic stroke patients, mean age was 70.2 ±13.5 years and 52% were men. Of these patients, 24% patients were non-overweight (BMI < 25), 34% were overweight (BMI 25-29.9) and 41% were obese (BMI ≥ 30). One-year survival probability was significantly higher in overweight patients (87%, 95% CI: [85.6 - 88.4], p<0.001) and obese patients (89.5%, 95% CI: [88.4 - 90.7], p<0.001) compared to non-overweight patients (78.1%, 95% CI: [76.0 - 80.1]). In multivariate analysis, one-year mortality was significantly lower in overweight and obese patients (overweight patients- HR = 0.61 [95% CI, 0.52 - 0.72]; obese patients- HR = 0.56 [95% CI, 0.48 - 0.67]). Other significant predictors of one-year mortality were age at the ischemic stroke event (HR = 1.04 [95% CI, 1.03 - 1.04]), history of neoplasm (HR = 1.59 [95% CI, 1.38 - 1.85]), atrial fibrillation or flutter (HR = 1.26 [95% CI, 1.09 - 1.46]), heart failure (HR = 1.68 [95% CI, 1.42 - 1.98]), diabetes mellitus (HR = 1.27 [95% CI, 1.1 - 1.47]), rheumatic disease (HR = 1.37 [95% CI, 1.05 - 1.78]) and myocardial infarction ((HR = 1.23 [95% CI, 1.02 - 1.48]). Conclusion: Our results support the obesity paradox in ischemic stroke patients as shown by a significantly decreased hazard ratio for one-year mortality among overweight and obese patients in comparison to non-overweight patients.

scholarly journals Relation Between Left Atrial Enlargement and Stroke Subtypes in Acute Ischemic Stroke Patients

2013 ◽  
Vol 15 (3) ◽  
pp. 131 ◽  
Author(s):  
Hye-Young Shin ◽  
In-Hye Jeong ◽  
Chang-Ki Kang ◽  
Dong-Jin Shin ◽  
Hyeon-Mi Park ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Left Atrial ◽  
Stroke Patients ◽  
Left Atrial Enlargement ◽  
Stroke Subtypes ◽  
Atrial Enlargement

scholarly journals Triglyceride glucose index influences platelet reactivity in acute ischemic stroke patients

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yinping Guo ◽  
Jing Zhao ◽  
Yi Zhang ◽  
Lingshan Wu ◽  
Zhiyuan Yu ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Platelet Reactivity ◽  
Multivariate Logistic Regression Analysis ◽  
Platelet Inhibition ◽  
Inhibition Rate ◽  
Stroke Patients ◽  
Tyg Index ◽  
Significant Difference

Abstract Aim Insulin resistance was reported to increase the risk of ischemic stroke, which can be assessed by the triglyceride glucose (TyG) index. However, it remains unclear whether the TyG index influences the platelet reactivity during the treatment of ischemic patients. Methods Ischemic stroke patients receiving dual antiplatelet therapy (DAPT) within 48 h onset were consecutively included. The TyG index was calculated as ln (fasting triglyceride [mg/dL] × fasting glucose [mg/dL]/2). The top quartile of TyG index was defined as insulin resistance. The platelet reactivity was assessed by thromboelastography. The platelet inhibition rate induced by arachidonic acid (AA) or adenosine diphosphate (ADP) was used to confirm the high residual on-treatment platelet reactivity (HRPR) to aspirin or clopidogrel, respectively. The association between TyG index and platelet reactivity was assessed by Kruskal–Wallis test. The independent risk factors of HRPR were determined by multivariate logistic regression analysis. Results A total of 1002 patients were included and divided into 4 groups by quartiles of the TyG index (< 2.02; 2.02–2.27; 2.27–2.52; ≥2.52). The findings demonstrated that the maximum intensity of the clot increased, but the AA-induced platelet inhibition rate decreased, depending on the TyG index quartiles. No significant difference was found in the ADP-induced platelet inhibition rate among groups. The prevalence of aspirin HRPR increased depending on the TyG index quartile. Unlike the non-insulin resistance group, the insulin resistance group was independently associated with aspirin HRPR (OR = 1.689, 95% CI 1.14 to 2.51, P = 0.009). Conclusions In acute ischemic stroke patients taking DAPT, the elevation of the TyG index is associated with enhanced platelet reactivity and higher prevalence of aspirin HRPR. Insulin resistance assessed by the TyG index could be an independent risk factor for aspirin HRPR.

scholarly journals Comparison of Ischemic and Hemorrhagic Stroke in the Medical Ward of Dessie Referral Hospital, Northeast Ethiopia: A Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Hussen Abdu ◽  
Fentaw Tadese ◽  
Girma Seyoum
Keyword(s):  
Ischemic Stroke ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Hemorrhagic Stroke ◽  
Medical Ward ◽  
Body Parts ◽  
Middle Cerebral Artery Territory ◽  
Common Site ◽  
Stroke Patients ◽  
Stroke Subtypes

Background. Distinguishing the category of stroke plays a vital role in planning patient care. Simple clinical findings help distinguish the type of stroke. However, there is a need for diagnostic imaging. In Ethiopia, stroke is the most common neurological condition in patients admitted to hospitals. Yet, there are limited data on comparisons of stroke subtypes. Thus, this study was designed to determine the prevalence of stroke and to compare ischemic and hemorrhagic strokes. Methods. A retrospective cross-sectional study design was employed. Medical records containing complete information and confirmed diagnosis using imaging techniques were included. The data were entered into SPSS version 24.0 for analysis. Results with a P value of <0.05 were considered statistically significant. Results. From a total of 312 stroke patients, 204 (65.4%) patients were admitted due to ischemic stroke. More females, 59 (18.9%), were admitted for hemorrhagic stroke than males. In both ischemic, 175 (56.1%) and hemorrhagic, 91 (29.2%) stroke cases, most of the patients were 45 years and above. Middle cerebral artery territory was the most common site of arterial territory infarctions in ischemic stroke, 158 (50.7%). Middle cerebral artery territory also was the most common site of hematoma in hemorrhagic stroke, 91 (29.2%). Infarctions in more than one lobe of the cerebrum (16.4%) and intracerebral hemorrhage in multiple areas of the cerebrum (7.4%) were observed in ischemic as well as hemorrhagic stroke cases. Most of the ischemic, 124 (39.8%), and hemorrhagic, 39 (12.5%), stroke patients presented loss of sensation and weakness of body parts. Hypertension was observed in 124 (39.8%) ischemic and 73 (23.4%) hemorrhagic stroke patients. The mortality rate of ischemic stroke, 47 (15.3%), was two times higher than hemorrhagic stroke, 20 (6.5%). Hypertension was the most common predictor of death in both ischemic and hemorrhagic stroke cases. Conclusions. Ischemic stroke is a common type of stroke in the medical ward of the study hospital. More females were affected by hemorrhagic stroke than males. Middle cerebral artery territory was the most affected area of the brain in both ischemic and hemorrhagic strokes. Most ischemic and hemorrhagic stroke patients were admitted due to loss of sensation and weakness of body parts. Hypertension was the most common risk factor of stroke as well as a predictor of stroke-related deaths. Identification of the stroke subtypes may be important in the management of stroke. Thus, health professionals, government officials, community leaders, and the population at large could be involved in creating awareness about antecedent risk factors and clinical presentations of stroke subtypes.

Stroke Subtypes and Comorbidity among Ischemic Stroke Patients in Brasilia and Cuenca: A Brazilian–Spanish Cross-cultural Study

2014 ◽  
Vol 23 (1) ◽  
pp. 140-147 ◽  
Author(s):  
Francisco Javier Carod-Artal ◽  
Jardiel Omar Casanova Lanchipa ◽  
Luis Miguel Cruz Ramírez ◽  
Noelia Sánchez Pérez ◽  
Fátima M. Siacara Aguayo ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Cultural Study ◽  
Cross Cultural ◽  
Stroke Patients ◽  
Stroke Subtypes ◽  
Cross Cultural Study

Abstract T P188: High Prevalence Of Igm Anti-phosphatidylserine-prothrombin Complex Antibodies And Lupus Anticoagulant In Patients With Non-lacunar Ischemic Stroke Without A Determined Cause

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Eisuke Furui ◽  
Ryo Itabashi ◽  
Yukako Yazawa ◽  
Masahide Yamazaki ◽  
Satoru Fujiwara
Keyword(s):  
Ischemic Stroke ◽  
Lupus Anticoagulant ◽  
Brain Mri ◽  
Arterial Stenosis ◽  
Enzyme Linked Immunosorbent Assay ◽  
Lacunar Stroke ◽  
Stroke Patients ◽  
Carotid Ultrasonography ◽  
Glycoprotein I ◽  
High Prevalence

Background and Purpose: The cause of ischemic stroke remains undetermined in about 25% of patients even after appropriate studies. Antiphospholipid syndrome (APS) is an autoimmune disease in which vascular thrombosis occurs in patients with antiphospholipid (aPL) antibodies. Anti-phosphatidylserine-prothrombin complex (aPS/PT) antibodies are reported to be associated with symptoms of APS and lupus anticoagulant (LAC) activity. Correlations between ischemic stroke and IgM aPS/PT antibodies have not been well investigated. We tried to explore possible correlations between non-lacunar ischemic stroke without a determined cause and aPL antibodies. Methods: Diagnostic studies consisted of brain MRI/CT, extracranial and intracranial MRA, carotid ultrasonography, 12-lead ECG, 24-hour ECG, transthoracic echo cardiography, transesophageal echo cardiography and venous ultrasonography. After excluding lacunar stroke, proximal arterial stenosis and caridoembolic sources with all these diagnositc studies, we selected 22 non-lacunalr ischemic stroke patients without a determined cause (age 48.5 +/- 14.4 years; 9 woman). We preliminarily measured IgG and IgM anticardiolipin (aCL) antibodies, IgG and IgM aPS/PT antibodies, anti-beta2-glycoprotein I-dependent cardiolipin (anti-beta2 GPI/CL) antibodies and LAC. aCL, aPS/PT, and anti-beta2 GPI/CL antibodies were measured by enzyme-linked immunosorbent assay. LAC was determined according to the Subcommittee on Lupus Anticoagulant/Phospholipid Dependent Antibody guidelines. Results: IgM aPS/PT antibodies, LAC, and both of them were detected in 10, 7, and 3 patients, respectively. Neither aCL nor anti-beta2 GPI/CL antibodies were identified in all patients. Conclusion: Our data demonstrate a high prevalence of IgM aPS/PT antibodies and LAC in patients with non-lacunar ischemic stroke without a determined cause. IgM aPS/PT antibodies and LAC might play some role in the development of ischemic stroke of these patients.

Abstract TP380: Significant Factors of Early Independent Gait in Acute Ischemic Stroke Patients

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Yuna Hosaka ◽  
Takahisa Mori ◽  
Yuki Sawada
Keyword(s):  
Ischemic Stroke ◽  
Acute Stroke ◽  
Acute Ischemic Stroke ◽  
Mmse Score ◽  
Lower Limbs ◽  
Upper Limbs ◽  
Stroke Patients ◽  
Trunk Control ◽  
Stroke Subtypes ◽  
Significant Factors

Introduction: Acute stroke patients have problems with gait disturbance. Independent gait in hospitalized patients is important for early discharge to home. Therefore, we must find factors of disturbing independent gait following acute stroke and intensively treat them. Hypothesis: Impaired trunk control and cognitive function are factors of disturbing early independent gait. Methods: We included acute ischemic stroke patients who were admitted in our hospital from June 2017 to May 2018 and excluded patients with disturbed level of consciousness. We defined a score of 6 (modified Independence) or 7 (complete independence) in the Functional Independence Measure (FIM) as gait independence. We evaluated association of stroke subtypes, Brunnstrom recovery stage (BRS) of upper limbs, fingers and lower limbs, trunk control test (TCT) score and Mini-Mental State Examination (MMSE) score with early gait independence on the 7th day of a stroke onset. Results: One hundred twenty- six patients met our inclusive criteria and we analyzed them. Stroke subtypes had no relation to early gait independence. In gait independent and dependent patients on the 7th day, median BRS score of upper limbs was 5 and 5 (ns), median BRS score of fingers was 5 and5 (ns), median BRS score of lower limbs was 6 and 5 (p<0.01), TCT score was 100and 75 (p<0.01) and MMSE score was 28.5 and 24.5 (p<0.01), respectively. Multiple logistic regression analysis that TCT (p<0.01) and BRS lower limbs (p<0.01) were independent factors for early independent gat. Receiver operating characteristic curve (ROC) for early gait independence demonstrated that cut-off values of TCT score and BRS of lower limbs and were 100 and 5. Conclusions: Impaired trunk control and muscle weakness of lower limbs were significant factors of disturbing early gait independence.

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