Abstract Details

Title Prolonged Elevation of Coated-Platelets in Patients with Mild Traumatic Brain Injury: Implications for Elevated Stroke Risk

Topic Neural Repair/Rehabilitation

Presentation(s) P04 - (-)

Poster/Presentation
Number 021

Objective

Background BACKGROUND: Coated-platelets are a subset of procoagulant platelets observed upon dual-agonist stimulation with collagen and thrombin. Coated-platelet levels are elevated in patients with cortical ischemic stroke compared to controls, and higher levels post-stroke are associated with an increased risk for stroke recurrence. Because of recent data showing an increased risk for stroke following traumatic brain injury, we undertook a pilot study to investigate coated-platelet synthesis in veterans with mTBI.

Design/Methods DESIGN/METHODS: Coated-platelet levels were determined in 40 patients with a diagnosis of mTBI and 36 controls, frequency matched for gender, race/ethnicity and age. The diagnosis of TBI was based on published criteria, and the mean elapsed time since injury was 6.9±2.9 years (mean±SD). Potential covariates included age, gender, race/ethnicity, medications that may influence coated-platelet levels, current smoking and presence of hypertension and diabetes. Baseline characteristics among the mTBI and control groups were compared using independent t-test, chi-square tests, or Fisher's exact test. Significance was set at 0.05.

Results RESULTS: Age, gender, race/ethnicity, smoking, medication use, hypertension, and diabetes were not significantly different between the two groups. Of these variables, only gender was significantly correlated with the outcome variable (P=0.01), therefore it was the only variable included as a covariate in the final model. After covariate adjustment, coated-platelet levels were significantly higher in mTBI patients compared to controls (52.0±14.0%, n=40 vs. 35.5±13.7, n=36, P<0.0001), and this difference was observed over an extended time period post injury (range 2-9 years).

Conclusions CONCLUSIONS: Coated-platelets are markedly increased in mTBI patients compared to controls. This is the first observation of increased platelet reactivity in this population and offers a unique insight into both the prolonged nature of the mTBI injury and to a possible mechanism for an increased risk of stroke.

Authors/Disclosures
Calin I. Prodan, MD (Univ of Oklahoma - Neurology Dept) PRESENTER	The institution of Dr. Prodan has received research support from US Department of Veterans Affairs (Merit award CX000340).
Andrea Vincent	Andrea Vincent has received personal compensation for serving as an employee of Vista LifeSciences. The institution of Andrea Vincent has received research support from Medical Technology Enterprise Consortium (MTEC).
George Dale	George Dale has nothing to disclose.
Francisco Barrero	No disclosure on file

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