(1) Background: An early diagnosis of a large vessel occlusion (LVO) is crucial in the management of the acute ischemic stroke (AIS). The laboratory predictors of LVO and a stroke outcome remain unknown. We have hypothesized that high MPV-a surrogate marker of the activated platelet-may be associated with LVO, and it may predict a worse AIS outcome. (2) Methods: This was a retrospective study of 361 patients with AIS who were treated with thrombolysis (tPA, 65.7%) and/or mechanical thrombectomy (MT, 34.3%) in a tertiary Stroke Center between 2011 and 2019. (3) Results: The mean MPV in the cohort was 9.86 ± 1.5 fL (1st-4th quartiles: <8.8, >10.80 fL). Patients in the 4th quartile compared to the 1st had a significantly (p < 0.01) more often incidence of an LVO related stroke (75% vs. 39%) and a severe stroke manifestation with a higher RACE score (5.2 ± 2.8 vs. 3.3 ± 2.4), NIHSS at baseline (mean ± SD, 14 ± 6.5 vs. 10.9 ± 5.2), and NIHSS at discharge (6.9 ± 7 vs. 3.9 ± 3.6). A multivariate analysis revealed that quartiles of MPV (OR 1.4; 95%CI 1.2-1.8) significantly predicted an LVO stroke, also after the adjustment for RACE < 5 (OR 1.4; 95%CI 1.08-1.89), but MPV quartiles did not predict a favorable stroke outcome (mRS ≤ 2) (OR 0.89; 95%CI 0.7-1.13). (4) Conclusion: Our data suggest that MPV is an independent predictor of LVO in patients with an acute ischemic stroke.
(1) Background: An early diagnosis of a large vessel occlusion (LVO) is crucial in the management of the acute ischemic stroke (AIS). The laboratory predictors of LVO and a stroke outcome remain unknown. We have hypothesized that high MPV-a surrogate marker of the activated platelet-may be associated with LVO, and it may predict a worse AIS outcome. (2) Methods: This was a retrospective study of 361 patients with AIS who were treated with thrombolysis (tPA, 65.7%) and/or mechanical thrombectomy (MT, 34.3%) in a tertiary Stroke Center between 2011 and 2019. (3) Results: The mean MPV in the cohort was 9.86 ± 1.5 fL (1st-4th quartiles: <8.8, >10.80 fL). Patients in the 4th quartile compared to the 1st had a significantly (p < 0.01) more often incidence of an LVO related stroke (75% vs. 39%) and a severe stroke manifestation with a higher RACE score (5.2 ± 2.8 vs. 3.3 ± 2.4), NIHSS at baseline (mean ± SD, 14 ± 6.5 vs. 10.9 ± 5.2), and NIHSS at discharge (6.9 ± 7 vs. 3.9 ± 3.6). A multivariate analysis revealed that quartiles of MPV (OR 1.4; 95%CI 1.2-1.8) significantly predicted an LVO stroke, also after the adjustment for RACE < 5 (OR 1.4; 95%CI 1.08-1.89), but MPV quartiles did not predict a favorable stroke outcome (mRS ≤ 2) (OR 0.89; 95%CI 0.7-1.13). (4) Conclusion: Our data suggest that MPV is an independent predictor of LVO in patients with an acute ischemic stroke.
Entities:
Keywords:
large vessel occlusion; mean platelet volume (MPV); mechanical thrombectomy; stroke; thrombolysis
Authors: Eric E Smith; David M Kent; Ketan R Bulsara; Lester Y Leung; Judith H Lichtman; Mathew J Reeves; Amytis Towfighi; William N Whiteley; Darin B Zahuranec Journal: Stroke Date: 2018-01-24 Impact factor: 7.914
Authors: J H Pexman; P A Barber; M D Hill; R J Sevick; A M Demchuk; M E Hudon; W Y Hu; A M Buchan Journal: AJNR Am J Neuroradiol Date: 2001-09 Impact factor: 3.825
Authors: Mirjam R Heldner; Christoph Zubler; Heinrich P Mattle; Gerhard Schroth; Anja Weck; Marie-Luise Mono; Jan Gralla; Simon Jung; Marwan El-Koussy; Rudolf Lüdi; Xin Yan; Marcel Arnold; Christoph Ozdoba; Pasquale Mordasini; Urs Fischer Journal: Stroke Date: 2013-03-07 Impact factor: 7.914
Authors: Zhong-Song Shi; David S Liebeskind; Bin Xiang; Sijian Grace Ge; Lei Feng; Gregory W Albers; Ronald Budzik; Thomas Devlin; Rishi Gupta; Olav Jansen; Tudor G Jovin; Monika Killer-Oberpfalzer; Helmi L Lutsep; Juan Macho; Raul G Nogueira; Marilyn Rymer; Wade S Smith; Nils Wahlgren; Gary R Duckwiler Journal: Stroke Date: 2014-05-29 Impact factor: 7.914