Association Between Mean Platelet Volume and Hemorrhagic Transformation in Acute Ischemic Stroke Patients

2020 ◽  
Vol 17 (1) ◽  
pp. 3-10
Author(s):  
Changyi Wang ◽  
Lu Wang ◽  
Linghui Deng ◽  
Shi Qiu ◽  
Shihong Zhang ◽  
...  

Background: Hemorrhagic transformation (HT) is a frequent complication of acute ischemic stroke (AIS). Mean platelet volume (MPV) is a marker of platelet function. The relationship between MPV and HT remains unclear. Methods: From January 1st, 2012 to December 31st 2016, we consecutively enrolled AIS patients admitted to the Department of Neurology of West China Hospital. MPV was measured on admission. HT was diagnosed by brain imaging and classified into hemorrhagic infarct (HI) and parenchymal hematoma (PH). Moreover, subjects were divided into tertiles according to MPV levels. Confounders were identified by univariate analysis and multivariate logistic regression was performed to explore the association between MPV and HT as well as HT subtypes. Also, a generalized additive model was used to investigate whether a non-linear association existed between MPV and HT. Results: A total of 783 AIS patients were included. 63 patients (8.0%) developed HT: 34 (4.3%) HI and 29 (3.7%) PH. It was observed that MPV positively correlated with HT. After adjustment for confounders, patients in the highest MPV tertile had a significantly increased risk of HT compared to patients in the lowest tertile (odds ratio 2.3, 95% confidence interval 1.0-5.4, P=0.04). The risk of HT increased step-wise across MPV tertiles (P for trend=0.04). MPV tertiles significantly correlated with HI rather than PH. The generalized additive model demonstrated a nonlinear association between MPV and HT (P=0.02). Conclusion: The risk of HT increased with increasing MPV level in a dose-dependent manner. Patients with elevated MPV levels were more likely to develop HI rather than PH.

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Malgorzata Miller ◽  
Nils Henninger ◽  
Renato Umeton ◽  
Agnieszka Slowik

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.


2019 ◽  
Vol 47 (1-2) ◽  
pp. 88-94 ◽  
Author(s):  
Changyi Wang ◽  
Linghui Deng ◽  
Shi Qiu ◽  
Haiyang Bian ◽  
Lu Wang ◽  
...  

Background and Objective: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke (AIS). Serum albumin is known for its neuroprotective effects and is a marker of improved AIS patient outcomes. However, it is not known whether there is a relationship between serum albumin and HT. Methods: AIS patients admitted to the Department of Neurology of West China Hospital from 2012 to 2016 were prospectively and consecutively enrolled. Baseline characteristics were collected. HT during hospitalization was diagnosed by brain imaging. Multivariate logistic regression analysis was performed to determine the relationship between serum albumin and HT. Confounding factors were identified by univariate analysis. Stratified logistic regression analysis was performed to identify effect modifiers. Results: A total of 1996 AIS patients were recruited, of whom 135 (6.8%) developed HT. Serum albumin negatively correlated with HT. Patients in the upper serum albumin tertile (42.6–54.1 g/L) had a 46% lower risk of HT than patients in the lower tertile (19.3–39.1 g/L) after adjustment for potential confounders (OR 0.54, 95% CI 0.29–0.99, p = 0.04). Risk of HT decreased stepwise with higher serum albumin tertile (p for trend = 0.04). There was a significant interaction between serum albumin and age (p = 0.02), with no significant correlation between serum albumin and HT in patients over 60 years of age. Conclusions: Higher serum albumin is associated with lower HT risk in a dose-dependent manner in AIS patients younger than 60 years.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Shadi Yaghi ◽  
Eva Mistry ◽  
Adam H De Havenon ◽  
Christopher Leon Guerrero ◽  
Amre Nouh ◽  
...  

Background and Purpose: Multiple studies have established that intravenous thrombolysis with alteplase improves outcome after acute ischemic stroke. However, assessment of thrombolysis’ efficacy in stroke patients with atrial fibrillation (AF) has yielded mixed results. We sought to determine the association of alteplase with mortality, hemorrhagic transformation (HT), infarct volume, and mortality in patients with AF and acute ischemic stroke. Methods: We retrospectively analyzed consecutive acute ischemic stroke patients with AF included in the Initiation of Anticoagulation after Cardioembolic stroke (IAC) study, which pooled data from 8 comprehensive stroke centers in the United States. 1889 (90.6%) had available 90-day follow up data and were included. For our primary analysis we used a cohort of 1367/1889 (72.4%) patients who did not undergo mechanical thrombectomy (MT). Secondary analyses were repeated in the patients that underwent MT (n=522). Binary logistic regression was used to determine whether alteplase use was independently associated with risk of HT, final infarct volume, and 90-day mortality, respectively, adjusting for potential confounders. Results: In our primary analyses we found that alteplase use was independently associated with an increased risk for HT (adjusted OR 2.14, 95% CI 1.49 - 3.07, p <0.001) but overall reduced risk of 90-day mortality (adjusted OR 0.58, 95% CI 0.39 - 0.87, p = 0.009). Among patients undergoing MT, alteplase use was associated with a trend towards a reduction in 90-day mortality (adjusted OR 0.68 95% CI 0.45 - 1.04, p = 0.077). In the subgroup of patients prescribed DOAC treatment (n = 327; 24 received alteplase), alteplase treatment was associated with a trend towards smaller infarct size (< 10 mL), (adjusted OR 0.40, 95% CI 0.15 - 1.12, p = 0.082) without a significant difference in the odds of 90-day mortality (adjusted OR 0.51, 95% CI 0.12 - 2.13, p = 0.357) or hemorrhagic transformation (adjusted OR 0.27, 95% CI 0.03 - 2.07, p = 0.206). Conclusion: Thrombolysis with intravenous alteplase was associated with reduced 90-day mortality in AF patients with acute ischemic stroke not undergoing MT. Further study is required to assess the safety and efficacy of alteplase in AF patients undergoing MT and those on DOACs.


Author(s):  
Al-Amir Bassiouny Mohamed ◽  
Hassan Mohamed Elnady ◽  
Hazem Kamal Alhewaig ◽  
Hesham Moslem Hefny ◽  
Ashraf Khodery

Platelets ◽  
2012 ◽  
Vol 24 (1) ◽  
pp. 75-76 ◽  
Author(s):  
Sun Young Cho ◽  
You La Jeon ◽  
Seok Keun Choi ◽  
Jin-Tae Suh ◽  
Hee Joo Lee ◽  
...  

Author(s):  
Besse Rosmiati ◽  
Sulina Y Wibawa ◽  
Darmawaty ER

Ischemic stroke is the cause of most cases which occur due to obstruction, this pathogenesis can be caused by the formation of thrombus in the cerebrum blood vessels. Platelet aggregation plays a role in the pathogenesis of thromboembolic cerebrovascular disease. Platelets size, measured as Mean Platelet Volume (MPV) is a marker of platelet function and is associated with the indicator of platelet activity. Several studies have found that there was an increased of MPV in acute ischemic stroke while the correlation with the severity and outcome of stroke was still controversial. The aim of study is to determine the MPV and their association with outcomes in acute ischemic stroke patients. A cohort study during May up to July 2010 was carried out, the researchers measured MPV and analyze their correlation with its outcome using modified Rankin scale score 10 days after the onset in 33 acute ischemic stroke patients. The mean of MPV for the first three days of the onset was 8.9 fl, on the 5th day was increased up to 9.4 but at the 10th day of onset the MPV remains the same value as the 5th day. The MPV of first three days and 5th day have a positive correlation, but insignificant with their outcome, with p values 0.158 and 0.06, respectively. From this study can be concluded that the increased of MPV on the fifth day onset did not have any significant correlation with the outcome of acute ischemic stroke illness.


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