DOI: http://dx.doi.org/10.18203/2349-3933.ijam20180474

A study on mean platelet volume in ischemic cerebrovascular stroke

Vitan Patel, Mahendra Parmar, Kinjal Shah, Rishikesh Joshi

Abstract


Background: Ischemic Cerebrovascular stroke is one of the largest cause of death and disability. It is usually caused by thrombosis or thromboembolic phenomena. Large platelets are more reactive, produce more prothrombotic factors and aggregate more easily, and can be a major risk factor/indicator for stroke. While the Mean Platelet Volume (MPV) has been studied in detail in cases of IHD, very few studies have been done in stroke, and none in India – prompting this study. We aim to determine whether an association exists between MPV and incidence/severity of stroke.

Methods: The study was carried out among fifty patients with an acute ischemic stroke. Clinical severity was assessed using Modified Rankin‘s scale. MPV was measured using an automated analyzer. Fifty controls were recruited and analysed.

Results: MPV has got a statistically significant correlation with Ischemic stroke with a p value of < 0.0001. Average MPV in cases was 9.78+1.25 fl vs. controls who average 8.30+1.14 fl. We did not find a statistically significant correlation between clinical severity of stroke and MPV (P = 0.550).

Conclusions: This study has shown an elevation of MPV in acute phase of Ischemic stroke. Within this relationship and adjusting for other significant variables in multivariate regression analysis, it can be stated that an increase in MPV is independently associated with stroke. Further research is required into the role of platelet volume in stroke pathology, outcome, and, most importantly, in individuals at risk for stroke. 


Keywords


Ischemic stroke, Mean platelet volume, Platelets, Stroke outcome

Full Text:

PDF

References


Global Health Estimates. Geneva: World Health Organization; 2012. Available at http://www.who.int/healthinfo/global_burden_disease/en/.

Smith N, Pathansali R, Bath P. Platelets and stroke. Vascular Medicine. 1999;4:165-172.

Bath PMW, Butterworth RJ. Platelet size: measurement, physiology and vascular disease. Blood. 1996;7:157-61.

Smith WS, English JD, Johnson SC. Cerebrovascular diseases. Harrison‘s Principles of Internal Medicine. Ed. Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL, et al 17th ed. Mc Graw Hill;Volume 2;2513-35.

Victor M, Ropper AH, Adams RD. Cerebrovascular diseases. Adam‘s and Victor‘s Principles of Neurology. Ed. Ropper AH, Samuels MA. 9th ed. United States of America, Mc Graw Hill;2009.

Pathansali R, Smith NM, Bath PM. Prothrombotic megakaryocyte and platelet changes in hypertension are reversed following treatment: a pilot study. Blood. 2001;12:144-9.

Ross R. Cell biology of atherosclerosis. Annual Review of Physiology. 1995;57:791-804 .

Greisenegger S, Endler G, Hsieh K, Tentschert S, Mannhalter C, Lalouschek W. Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebrovascular events? Stroke. 2004;35:1688-91.

Smith N, Pathansali R, Bath P. Platelets and stroke. Vascular Med. 1999;4:165-72.

Harrison’s principles of internal medicine. 19th ed. 2015;2400.

Owolabi MO, Akarolo-Anthony S, Akinyemi R, Arnett D, Gebregziabher M, Jenkins C, et al. Members of the H3Africa Consortium. The burden of stroke in Africa: a glance at the present and a glimpse into the future. Cardiovasc J Afr. 2015;26(2) Suppl 1:S27-38.

Gibson CL. Cerebral ischemic stroke: is gender important? Journal of cerebral blood flow and metabolism: official journal of the International Society of Cerebral Blood Flow and Metabolism. 2013;33(9):1355-61.

Butterworth RJ, Bath PM. The relationship between mean platelet volume, stroke subtype and clinical outcome. Platelets. 1998;9:359-64.

O’Malley T, Langhorne P, Elton RA, Stewart C. Platelet size in stroke patients. Stroke. 1995;26:995-9.

Tohgi H, Suzuki H, Tamura K, Kimura B. Platelet volume, aggregation, and adenosine triphosphate release in cerebral thrombosis. Stroke. 1991;22:17-21.