Contributions
Abstract: EP1323
Type: E-Poster Presentation
Session title: Thrombosis and vascular biology - Biology & Translational Research
Background
Incidence of stroke in Europe is 95 to 290/100,000 per year and it is the fourth cause of death in the United States. The important role of platelets in the pathogenesis of the acute stroke (AS) (atherothrombosis and ischemic) has been documented. Mean platelet volume (MPV) is regarded as a marker of platelet turnover. More immature, thereby larger platelets usually contain more granules, thus releasing more chemokines promoting further platelet aggregation as well as activation. Elevated MPV simultaneously with the elevated PC increases the risk of thrombosis. Significant increased MPV in patients with deep vein thrombosis and isolated elevated platelet count (PC) in patients with pulmonary embolism has been revealed.
Modification of platelet function and consequently a hypercoagulable state has been suggested in patients with both ischemic and hemorrhagic strokes. It has been shown that PC and MPV are independent predictors for poor outcome in primary intracerebral hemorrhage (PICH). There has also been a body of interest for PC and MPV in stroke patients. However, these studies have yielded inconsistent findings. Some groups reported that patients with AS had significantly increased MPV or PC compared with controls, whereas other studies found decreased MPV or PC values in AS patients . Additionally, some studies have observed no association between these parameters and AS .
Aims
Taking these inconsistent findings into consideration, we undertook a meta-analysis to investigate the association between MPV, PC and AS.
Methods
Studies were included in accordance with Patient Population or Problem, Intervention, Comparison, Outcomes, and Setting framework. The PRISMA strategy was used to report findings. Risk of bias was assessed with the Newcastle-Ottawa Scale.
Results
We included 34 eligible articles retrieved from the literature. PC was significantly lower in AS patients [standardized mean difference (SMD) = − 0.30, (95%CI: − 0.49 – − 0.11), N = 2492, P = 0.002] compared with controls (N = 3615). The MPV was significantly higher [SMD = 0.52, (95%CI: 0.28 – 0.76), N = 2739, P < 0.001] compared with controls (N = 3810). Subgroup analyses showed significantly lower PC in both ischemic stroke (Difference SMD = − 0.18, 95%CI: − 0.35 – 0.01) and hemorrhagic stroke (− 0.94, − 1.62 – − 0.25), but only samples by citrate anticoagulant showed significantly lower result for patients compared to controls (− 0.36, − 0.68 – − 0.04). Ischemic stroke patients had higher MPV (0.57, 0.31 – 0.83), and samples by Ethylenediaminetetraacetic acid (EDTA) anticoagulant showed significantly higher result for patients compared to controls (0.86, 0.55 – 1.17).
Conclusion
PC and MPV appeared to be significantly different between patients with AS and control populations. MPV was significantly higher in ischemic stroke and PC was significantly lower in both ischemic and hemorrhagic strokes. These characteristics might be related to AS and associated with it. It is advisable to pay attention to elapsed time between phlebotomy and hematology analysis, anticoagulant and hemocytometer types in AS.
Keyword(s): Platelet count, Stroke
Abstract: EP1323
Type: E-Poster Presentation
Session title: Thrombosis and vascular biology - Biology & Translational Research
Background
Incidence of stroke in Europe is 95 to 290/100,000 per year and it is the fourth cause of death in the United States. The important role of platelets in the pathogenesis of the acute stroke (AS) (atherothrombosis and ischemic) has been documented. Mean platelet volume (MPV) is regarded as a marker of platelet turnover. More immature, thereby larger platelets usually contain more granules, thus releasing more chemokines promoting further platelet aggregation as well as activation. Elevated MPV simultaneously with the elevated PC increases the risk of thrombosis. Significant increased MPV in patients with deep vein thrombosis and isolated elevated platelet count (PC) in patients with pulmonary embolism has been revealed.
Modification of platelet function and consequently a hypercoagulable state has been suggested in patients with both ischemic and hemorrhagic strokes. It has been shown that PC and MPV are independent predictors for poor outcome in primary intracerebral hemorrhage (PICH). There has also been a body of interest for PC and MPV in stroke patients. However, these studies have yielded inconsistent findings. Some groups reported that patients with AS had significantly increased MPV or PC compared with controls, whereas other studies found decreased MPV or PC values in AS patients . Additionally, some studies have observed no association between these parameters and AS .
Aims
Taking these inconsistent findings into consideration, we undertook a meta-analysis to investigate the association between MPV, PC and AS.
Methods
Studies were included in accordance with Patient Population or Problem, Intervention, Comparison, Outcomes, and Setting framework. The PRISMA strategy was used to report findings. Risk of bias was assessed with the Newcastle-Ottawa Scale.
Results
We included 34 eligible articles retrieved from the literature. PC was significantly lower in AS patients [standardized mean difference (SMD) = − 0.30, (95%CI: − 0.49 – − 0.11), N = 2492, P = 0.002] compared with controls (N = 3615). The MPV was significantly higher [SMD = 0.52, (95%CI: 0.28 – 0.76), N = 2739, P < 0.001] compared with controls (N = 3810). Subgroup analyses showed significantly lower PC in both ischemic stroke (Difference SMD = − 0.18, 95%CI: − 0.35 – 0.01) and hemorrhagic stroke (− 0.94, − 1.62 – − 0.25), but only samples by citrate anticoagulant showed significantly lower result for patients compared to controls (− 0.36, − 0.68 – − 0.04). Ischemic stroke patients had higher MPV (0.57, 0.31 – 0.83), and samples by Ethylenediaminetetraacetic acid (EDTA) anticoagulant showed significantly higher result for patients compared to controls (0.86, 0.55 – 1.17).
Conclusion
PC and MPV appeared to be significantly different between patients with AS and control populations. MPV was significantly higher in ischemic stroke and PC was significantly lower in both ischemic and hemorrhagic strokes. These characteristics might be related to AS and associated with it. It is advisable to pay attention to elapsed time between phlebotomy and hematology analysis, anticoagulant and hemocytometer types in AS.
Keyword(s): Platelet count, Stroke