Abstract Details

Title Increased Platelet Procoagulant Potential is Associated with Silent Brain Infarcts in Ischemic Stroke Patients

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P5 - Poster Session 5 (11:45 AM-12:45 PM)

Poster/Presentation
Number 4-004

Objective

To evaluate if platelet procoagulant potential is associated with the presence of silent brain infarcts (SBIs) in ischemic stroke.

Background Coated-platelets, a subset of highly procoagulant platelets observed upon dual-agonist stimulation with collagen and thrombin, represent ~32% of all platelets in healthy controls. Elevated coated-platelet levels are associated with increased risk for recurrence in patients with ischemic stroke, whereas lower levels of coated-platelets are present with early hemorrhagic transformation or hemorrhagic complications after stroke. SBIs are common in elderly patients with stroke.

Design/Methods Coated-platelet levels, reported as percent of cells converted to coated-platelets, were assayed in consecutive ischemic stroke patients <96 hours from symptoms onset. Subjects with intracerebral hemorrhage, myocardial infarction, dementia or recent blood transfusions were excluded. Demographics, medications, comorbidities, and laboratory values were recorded for each participant. The presence of SBIs on 1.5 T MRI was recorded by two independent reviewers. Logistic regression was used to identify factors associated with SBI presence. Correlations between number of SBIs and coated-platelet levels, demographics, and clinical and laboratory data were calculated using the Spearman correlation coefficient.

Results We analyzed 249 stroke patients, with a mean age of 65.7 years (range 42-91) and mean coated-platelet levels of 39% (SD 14.4%). Logistic regression identified coated-platelet levels, mean platelet volume, hypertension, obesity, hyperlipidemia and prior stroke as independently associated with SBI presence (p values <0.04). After adjusting for all variables in the model, a 10% absolute increase in coated-platelet levels was associated with 80% higher odds of SBI (95 CI:44%-124%). The numbers of SBIs correlated positively with coated-platelet levels, after adjusting for hypertension, hyperlipidemia, and prior stroke (adjusted r=0.4 , p<0.001).

Conclusions Increased platelet procoagulant potential is associated with the presence and the number of SBIs in stroke patients. These results support a role for procoagulant platelets in ischemic stroke, with implications for recurrence and vascular cognitive impairment.

Authors/Disclosures
Philion Gatchoff, MD (OU Health) PRESENTER	Dr. Gatchoff has nothing to disclose.
Angelia Kirkpatrick	Angelia Kirkpatrick has nothing to disclose.
Chao Xu	Chao Xu 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).
Bappaditya Ray, MD (UT Southwestern Medical Center)	Dr. Ray has nothing to disclose.
Sergio A. Ramirez-Salazar, MD (Dartmouth Hitchcock Medical Center)	Dr. Ramirez-Salazar has nothing to disclose.
Meheroz H. Rabadi, MD, FAAN (Dept of VA Medical Center #127)	Dr. Rabadi 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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