Higher Coated-Platelet Levels are Associated with Stroke Recurrence following Nonlacunar Brain Infarction

• Published in: Journal of cerebral blood flow and metabolism Vol. 33; no. 2; pp. 287 - 292
• Main Authors: Prodan, Calin I, Stoner, Julie A, Cowan, Linda D, Dale, George L
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.02.2013; Sage Publications Ltd; Nature Publishing Group
• Subjects: Adult; Aged; Aged, 80 and over; Blood Platelets - metabolism; Blood Platelets - pathology; Brain; Brain Infarction - blood; Brain Infarction - complications; Brain Infarction - epidemiology; Cerebral blood flow; Cerebral infarction; Collagen; Collagen - metabolism; Data processing; Female; Follow-Up Studies; Hemorrhage; Humans; Incidence; Ischemia; Male; Middle Aged; Original; Platelet Function Tests; Platelets; Risk factors; Stroke; Stroke - blood; Stroke - epidemiology; Stroke - etiology; Thrombin; Thrombin - metabolism; recurrence; thrombosis; stroke; platelets
• ISSN: 0271-678X; 1559-7016; 1559-7016
• DOI: 10.1038/jcbfm.2012.168

Coated-platelets are procoagulant platelets observed upon dual-agonist stimulation with collagen and thrombin. Coated-platelet levels are elevated in patients with nonlacunar (large-vessel) ischemic stroke and decreased in patients with spontaneous intracerebral hemorrhage as compared with controls. The purpose of this study was to investigate a possible relationship between coated-platelet levels and stroke recurrence in patients with nonlacunar ischemic stroke. We assayed coated-platelet levels in 190 consecutive patients with nonlacunar stroke who were followed for up to 12 months; 20 subjects experienced recurrent stroke. Subjects were categorized into tertiles of coated-platelet levels. The distributions of time-to-recurrent stroke were estimated for each tertile using cumulative incidence curves and compared statistically using a log-rank test. The cumulative incidence of recurrent stroke at 12 months differed among the coated-platelet tertiles: 2% for the first tertile (lowest coated-platelet levels), 18% for the second tertile, and 17% for the third tertile (overall log-rank test, P = 0.019). These data suggest that higher levels of coated-platelets, measured shortly after a nonlacunar stroke, are associated with an increased incidence of stroke recurrence. This observation offers an additional tool for identifying patients at highest risk for stroke recurrence following a nonlacunar (large-vessel) infarct.