Measurement of platelet fibrinogen binding and p-selectin expression by flow cytometry in patients with cerebral infarction.

We determined the percentages of fibrinogen-bound and P-selectin-expressed platelets in whole blood using flow cytometry in 254 patients with various cerebral infarction subtypes, as well as in 30 age-matched controls. Patients with atherothrombotic stroke showed significant increases in both fibrinogen-bound and P-selectin-expressed platelets. Patients with lacunar stroke also showed significant increases in both of them, but the percentage of P-selectin expression was significantly lower than that in atherothrombotic stroke. Patients with cardioembolic stroke showed a significant increase in P-selectin-expressed platelets without any increase in fibrinogen-bound platelets. Platelet fibrinogen binding and P-selectin expression were significantly lower in patients treated with ticlopidine but not with aspirin than in those not treated with any antiplatelet agent, and were lowest in those treated with both ticlopidine and aspirin. Our findings suggest that expression of adhesion molecules on platelet membrane surface differs among the patients with subtypes of ischemic stroke and differs among the types of antiplatelet regimens.