Abstract Details

Title IL-2 Levels, Smoking, and Number of Injuries Correlate with Platelet Procoagulant Potential in Veterans with Mild TBI - Supporting a Link Between Prior Injury and Long-term Risk of Stroke

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P10 - Poster Session 10 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-011

Objective To explore mechanisms associated with increased platelet procoagulant potential in patients with mild traumatic brain injury (mTBI).

Background Coated-platelets are a subset of highly procoagulant platelets, observed upon dual-agonist stimulation with collagen and thrombin. While in healthy controls they represent ~32% of all platelets, elevated coated-platelet levels are present in patients with ischemic stroke and are associated with increased risk for infarct recurrence. Prior work, prompted by the recognition of stroke as a long-term complication of TBI, showed elevated coated-platelet levels in mTBI patients several years after the injury. Furthermore, a relationship between increased number of injuries and increased coated-platelet potential was observed.

Design/Methods Coated-platelet levels (expressed as percentage of platelets) were assayed as previously described in veterans with combat related mTBI. Subjects with moderate/severe TBI, prior stroke/TIA, intracerebral hemorrhage, dementia, bleeding diatheses or recent blood transfusions were excluded. An array of 27 inflammatory markers was assessed with a multiplex assay system for each patient. Demographics, medications, number and timing of injuries, and comorbidities were recorded for each participant. Regression analysis was conducted to assess factors associated with coated-platelet levels.

Results

We enrolled 39 randomly selected veterans with mTBI (>14 months from the last injury), with a mean age of 38 years (range 27-54), and mean coated-platelet levels of 37.2% (SD 13.3%). The following inflammatory markers and clinical variables showing associations with coated-platelet levels at P≤0.15 were included as predictors in a multiple regression analysis: IL-2, IL-10, IL-15, GM-CSF, injury type, smoking status, and number of injuries. The model accounted for 51.8% of the variance in coated-platelet levels. Only IL-2, number of injuries and smoking retained significance in the full model.

Conclusions These results support the existence of a possible molecular link between TBI and the long-term risk of stroke through thrombotic and inflammatory mechanisms. Further examination of the mechanisms involved is warranted.

Authors/Disclosures
Zalan B. Kaposzta, MD, PhD Candidate PRESENTER	Dr. Kaposzta has nothing to disclose.
Philion Gatchoff, MD (OU Health)	Dr. Gatchoff has nothing to disclose.
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).
Eleanor Mathews	Eleanor Mathews has nothing to disclose.
Leslie Guthery	Leslie Guthery has nothing to disclose.
Andriy Yabluchanskiy	Andriy Yabluchanskiy has nothing to disclose.
Angelia Kirkpatrick	Angelia Kirkpatrick has nothing to disclose.
George Dale	George Dale has nothing to disclose.
Calin I. Prodan, MD (Univ of Oklahoma - Neurology Dept)	The institution of Dr. Prodan has received research support from US Department of Veterans Affairs (Merit award CX000340).

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