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.
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| http://dx.doi.org/10.1038/jcbfm.2012.168 | DOI Listing |
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Article Synopsis
- Coated-platelet levels are lower in patients with lacunar strokes compared to non-lacunar strokes, and higher levels are linked to increased risks of recurrent strokes and TIAs (transient ischemic attacks).
- This study assessed coated-platelet levels in 109 patients with acute lacunar strokes over a 12-month follow-up, aiming to determine if these levels could predict the occurrence of recurrent strokes and TIAs.
- The findings revealed that a coated-platelet level cut-off of 42.6% effectively differentiated patients at higher risk for recurrent events, with a significant hazard ratio indicating much greater risk for those above this threshold.
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