Abstract Details

Title Platelet Procoagulant Potential Declines with Age in Healthy Controls – A Link to Hemorrhagic Complications in Elderly?

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P9 - Poster Session 9 (5:00 PM-6:00 PM)

Poster/Presentation
Number 4-006

Objective To examine the relationship between platelet procoagulant potential and age in healthy controls.

Background

Coated-platelets, a subset of highly procoagulant platelets, are observed upon dual-agonist stimulation with collagen and thrombin; they represent ~32% of all platelets in healthy controls. Coated-platelet levels are elevated in patients with ischemic stroke/TIA, with higher levels associated with increased risk for recurrence. In contrast, lower levels of coated-platelets are present in patients with hemorrhagic complications after stroke and in humans/animals with bleeding diatheses. While smoking is associated with increased levels, chronic use of statins, SSRIs or antiplatelets is associated with decreased levels.

Design/Methods Coated-platelet levels (expressed as percentage of platelets) were assayed as previously described. Subjects with prior stroke/TIA, intracerebral/subarachnoid hemorrhage, myocardial infarction, dementia, traumatic brain injury, bleeding diatheses or recent blood transfusions were excluded. Demographics, medications, and comorbidities were recorded for each participant. Individuals performing the coated-platelet assays were not aware of clinical data. Regression analysis was conducted to assess the relationship between coated-platelet levels and age.

Results We enrolled 200 control subjects, with a mean age of 57 years (range 21-94 years), and mean coated-platelet levels of 34.3% (SD 13.6%). Logistic regression identified age and smoking as independently associated with coated-platelet levels (p=0.03). Every decade of increased age was associated with a mean 1.6% decrease in the coated-platelet levels (p=0.02), with a steeper decline noted after age 75. Smokers had higher coated-platelet levels than non-smokers (38±13.4%, N=60 vs 32.8±13.4%, N=140, p=0.007). None of the remaining variables confounded the association between age and coated-platelet levels.

Conclusions Aging is associated with a decline in platelet procoagulant potential in controls, most noticeable after age 75. These results suggest a link to previously reported increased risk of major hemorrhagic complications with antithrombotic therapy in the elderly and deserve further examination of mechanisms involved.

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).
Eleanor Mathews	Eleanor Mathews has nothing to disclose.
Leslie Guthery	Leslie Guthery has nothing to disclose.
Fabiola Donna-Ferreira, MD	Dr. Donna-Ferreira 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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