ASSOCIATION AND CORRELATION OF MEAN PLATELET VOLUME AND PLATELET COUNT IN ACUTE ISCHEMIC STROKE
DOI:
https://doi.org/10.22159/ajpcr.2022.v15i9.45904Keywords:
Mean platelet volume,, Platelet countAbstract
Objective: Role of platelets in the pathogenesis of the atherothrombosis and ischemic stroke has been documented. Mean platelet volume (MPV) and platelet count (PC) could be important predictors of acute ischemic stroke (AIS), its severity; therefore we investigated the correlation of MPV & PC in AIS patients.
Methods: We studied MPV and PC of 52 AIS patients consecutively admitted in Neurology department at Geetanjali Medical University, India. Platelet variables were measured and compared with control of similar age, sex and without vascular events.
Results: Out of 52 patients, 30 (57.69%) had Thirty (57.69%) patients had significantly higher MPV in AIS group (12.45fL compared with normal range of 6–11 fL in control,p<0.001). No significant differences were found between male and females, but the total mean was elevated. The mean of PC was 1.76×105 cells/cumm (normal range) and there was no correlation between the change in PC and AIS in both sexes. Repeated measurements of MPV and PC were also recorded on follow-up which showed no significant changes from the acute phase; however, MPV remained elevated. The comparison of MPV in patients with mRS score 2 versus 4, 2 versus 5, 3 versus 4 and 5, and 4 versus 5 were found to be statistically significant (p<0.05).
Conclusion: Increased MPV has an independent association with AIS and its severity and it could not change after acute treatment. It is possible that these changes precede the vascular event, and further studies are warranted to unravel the underlying mechanism.
Downloads
References
Kamalakannan S, Gudlavalleti AS, Gudlavalleti VS, Goenka S, Kuper H. Incidence and prevalence of stroke in India: A systematic review. Indian J Med Res 2017;146:175-85. doi: 10.4103/ijmr. IJMR_516_15
World Health Organization. Global Health Estimates. Geneva: World Health Organization; 2012. Available from: https://www.who.int/ healthinfo/global_burden_disease/en
Smith NM, Pathansali R, Bath PM. Platelets and stroke. Vasc Med 1999;4:165-72. doi: 10.1177/1358836X9900400307
Tsai NW, Chang WN, Shaw CF, Jan CR, Chang HW, Huang CR, et al. Levels and value of platelet activation markers in different subtypes of acute non-cardio-embolic ischemic stroke. Thromb Res 2009;124:213- 8. doi: 10.1016/j.thromres.2009.01.012
Rodrigues B, Staff I, Fortunato G, McCullough LD. Hyponatremia in the prognosis of acute ischemic stroke. J Stroke Cerebrovasc Dis 2014;23:850-4. doi: 10.1016/j.jstrokecerebrovasdis.2013.07.011
Tombul T, Atbas C, Anlar O. Hemostatic markers and platelet aggregation factors as predictive markers for type of stroke and neurological disability following cerebral infarction. J Clin Neurosci 2005;12:429-34. doi: 10.1016/j.jocn.2004.06.013
Kamisli O, Kamisli S, Kablan Y, Gonullu S, Ozcan C. The prognostic value of an increased mean platelet volume and platelet distribution width in the early phase of cerebral venous sinus thrombosis. Clin Appl Thromb Hemost 2013;19:29-32. doi: 10.1177/1076029612453196
Pathansali R, Smith NM, Bath PM. Prothrombotic megakaryocyte and platelet changes in hypertension are reversed following treatment: A pilot study. 2001;12:144-9. doi: 10.1080/09537100120039000
Kaplan ZS, Jackson SP. The role of platelets in at herothrombosis. Hematology Am Soc Hematol Educ Program 2011;2011:51-61. doi: 10.1182/asheducation-2011.1.51
Schmalbach B, Stepanow O, Jochens A, Riedel C, Deuschl G, Kuhlenbaumer G. Determinants of platelet-leukocyte aggregation and platelet activation in stroke. Cerebrovasc Dis 2015;39:176-80. doi: 10.1159/000375396
Thomson CB, Jakubowski JA, Quinn PG, Deykin D, Valeri CR. Platelet size as a determinant of platelet function. J Lab Clin Med 1981;97:187-204.
Brown AS, Hong Y, de Belder A, Beacon H, Beeso J, Sherwood R, et al. Megakaryocyte ploidy and platelet changes in human diabetes and atherosclerosis. Arterioscler Thromb Vasc Biol 1997;17:802-7. doi: 10.1161/01.atv.17.4.802
Liu L, Lin Z, Shen Z, Zhang G, Li S, Cao P. Platelet hyperfunction exists in both acute non-haemorrhagic and haemorrhagic stroke. Thromb Res 1994;75:485-90. doi: 10.1016/0049-3848(94)90264-x
Bath P, Algert C, Chapman N, Neal B. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke 2004;35:622-6. doi: 10.1161/01. STR.0000116105.26237.EC
O’Malley T, Langhorne P, Elton RA, Stewart C. Platelet size in stroke patients. Stroke 1995;26:995-9. doi: 10.1161/01.str.26.6.995
Rankin J. Cerebral vascular accidents in patients over the age of 60. II. Prognosis. Scott Med J 1957;2:200-15. doi: 10.1177/003693305700200504
Bonita R, Beaglehole R. Recovery of motor function after stroke. Stroke 1988;19:1497-500. doi: 10.1161/01.str.19.12.1497
Hoffmann J. Reference range of mean platelet volume. Thromb Res 2012;129:534-5. doi: 10.1016/j.thromres.2011.11.012
Mitchell Lewis S. Reference ranges and normal values. In: Dacie and Lewis Practical Haematology. 10th ed., Ch. 2. United Kingdom: Churchill Livingstone; 2006. p. 17-20.
Martin JF, Trowbridge EA, Salmon G, Plumb J. The biological significance of platelet volume: Its relationship to bleeding time,
platelet thromboxane B2 production and megakaryocyte nuclear DNA concentration. Thromb Res 1983;32:443-60. doi: 10.1016/0049- 3848(83)90255-4
Shah PA, Mir RA, Kamili MM, Bardi GH, Masoodi ZA. Role of mean platelet volume in ischemic stroke. JK Science 2013;15:136-9.
Whitelock G, Mac Mohan S, Anderson C, Neal B, Rodgers A, Chalmers J. Blood pressure lowering for the prevention of cognitive decline in patients with cerebrovascular disease. PROGRESS management committee. Perinotrophil protection against recurrent stroke study. Clin Exp Hypertens 1997;19:843-55. doi: 10.3109/10641969709083190
Pikija S, Cvetk D, Hajduk M, Trkulja V. Higher mean platelet volume determined shortly after the symptom onset in acute ischemic stroke patients is associated with a larger infarct volume on CT brain scans and with worse clinical outcome. Clin Neurol Neurosurg 2009;111:568-73. doi: 10.1016/j.clineuro.2009.04.002
Poornima R, Raghu N, Kanagasabai V. Assesment of mean platelet volume in ischemic stroke and its correlation with prognosis and severity. IIM MMC 2013;8:47-51.
Martin JF, Plumb J, Kilbey RS, Kishk YT. Changes in volume and density of platelets in myocardial infarction. Br Med J (Clin Res Ed) 1983;287:456-60. doi: 10.1136/bmj.287.6390.456
Published
How to Cite
Issue
Section
Copyright (c) 2022 YASH PATEL, VINOD KUMAR MEHTA, RENU KHAMESRA, AYUSHI JAIN, VYAS KK
This work is licensed under a Creative Commons Attribution 4.0 International License.
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.