The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis

Jacek Staszewski,1 Aleksandra Pogoda,1 Kamila Data,1 Klaudia Walczak,1 Maciej Nowocień,2 Emilia Frankowska,2 Adam Stępień1 1Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland; 2Department of Radiology, Military Institute of Medicine, Warsaw, Poland Purpose: The role of biomarkers...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Staszewski J, Pogoda A, Data K, Walczak K, Nowocień M, Frankowska E, Stępień A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2019
Materias:	acute ischemic stroke rt-PA prognosis MPV biomarker Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/04b7df52796f4474919b79891ac4ce84
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:04b7df52796f4474919b79891ac4ce84
record_format	dspace
spelling	oai:doaj.org-article:04b7df52796f4474919b79891ac4ce842021-12-02T00:49:08ZThe mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis1178-1998https://doaj.org/article/04b7df52796f4474919b79891ac4ce842019-02-01T00:00:00Zhttps://www.dovepress.com/the-mean-platelet-volume-on-admission-predicts-unfavorable-stroke-outc-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Jacek Staszewski,1 Aleksandra Pogoda,1 Kamila Data,1 Klaudia Walczak,1 Maciej Nowocień,2 Emilia Frankowska,2 Adam Stępień1 1Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland; 2Department of Radiology, Military Institute of Medicine, Warsaw, Poland Purpose: The role of biomarkers in the prediction of acute ischemic stroke (AIS) outcome or response to thrombolytic therapy (with recombinant tissue plasminogen activator [rt-PA]) remains limited. The aim of this study was to evaluate whether mean platelet volume (MPV) could predict short-term functional outcome in patients with AIS following rt-PA treatment.Patients and methods: This was a retrospective analysis of 237 AIS patients (mean age 71.04±0.8 years, 50.6% women) consecutively admitted to a tertiary care center between 2011 and 2015.Results: The mean MPV in the cohort was 9.8±0.35 fL (lowest tertile 8.8 fL). Patients in the lowest tertile compared to median and highest tertiles were less often dependent (modified Rankin scale [mRS] ≥3) at admission (87.2% vs 96.1% and 96.1%, respectively, P=0.04) and less often had a poor stroke outcome (mRS 4–6) at discharge (28.2% vs 55.3% and 44.7%, P<0.01). However, there was no significant difference between tertiles with regard to AIS etiology, CT (Alberta Stroke Program Early CT) score, frequency of stroke due to large artery occlusion, risk of secondary hemorrhage, and early neurologic deterioration. Multivariable analysis after adjustment for confounders showed that patients in the second and third tertiles had a significantly higher risk of poor stroke outcome (OR =1.9, 95% CI =1.01–4), lack of early improvement (OR =1.91, 95% CI =1.05–3.47), lower chance of good outcome (mRS 0–2; OR =0.38, 95% CI =0.18–0.78), or minor stroke at discharge (OR =0.47, 95% CI =0.26–0.84). Receiver operating characteristic analysis for prediction of poor stroke outcome showed that the optimal cut-off point of MPV was 8.8 fL (area under the curve 0.586 [0.512–0.659], P=0.03) with a sensitivity of 82.7% and a specificity of 43.9%.Conclusion: Disabling or fatal ischemic stroke in thrombolyzed patients was observed more often in patients with high admission MPV. The prognostic value of MPV was independent of other well-defined individual risk factors. Keywords: acute ischemic stroke, rt-PA, prognosis, MPV, biomarker, platelet activity, reperfusion  Staszewski JPogoda AData KWalczak KNowocień MFrankowska EStępień ADove Medical Pressarticleacute ischemic strokert-PAprognosisMPVbiomarkerGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 14, Pp 493-503 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute ischemic stroke rt-PA prognosis MPV biomarker Geriatrics RC952-954.6
spellingShingle	acute ischemic stroke rt-PA prognosis MPV biomarker Geriatrics RC952-954.6 Staszewski J Pogoda A Data K Walczak K Nowocień M Frankowska E Stępień A The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis
description	Jacek Staszewski,1 Aleksandra Pogoda,1 Kamila Data,1 Klaudia Walczak,1 Maciej Nowocień,2 Emilia Frankowska,2 Adam Stępień1 1Clinic of Neurology, Military Institute of Medicine, Warsaw, Poland; 2Department of Radiology, Military Institute of Medicine, Warsaw, Poland Purpose: The role of biomarkers in the prediction of acute ischemic stroke (AIS) outcome or response to thrombolytic therapy (with recombinant tissue plasminogen activator [rt-PA]) remains limited. The aim of this study was to evaluate whether mean platelet volume (MPV) could predict short-term functional outcome in patients with AIS following rt-PA treatment.Patients and methods: This was a retrospective analysis of 237 AIS patients (mean age 71.04±0.8 years, 50.6% women) consecutively admitted to a tertiary care center between 2011 and 2015.Results: The mean MPV in the cohort was 9.8±0.35 fL (lowest tertile 8.8 fL). Patients in the lowest tertile compared to median and highest tertiles were less often dependent (modified Rankin scale [mRS] ≥3) at admission (87.2% vs 96.1% and 96.1%, respectively, P=0.04) and less often had a poor stroke outcome (mRS 4–6) at discharge (28.2% vs 55.3% and 44.7%, P<0.01). However, there was no significant difference between tertiles with regard to AIS etiology, CT (Alberta Stroke Program Early CT) score, frequency of stroke due to large artery occlusion, risk of secondary hemorrhage, and early neurologic deterioration. Multivariable analysis after adjustment for confounders showed that patients in the second and third tertiles had a significantly higher risk of poor stroke outcome (OR =1.9, 95% CI =1.01–4), lack of early improvement (OR =1.91, 95% CI =1.05–3.47), lower chance of good outcome (mRS 0–2; OR =0.38, 95% CI =0.18–0.78), or minor stroke at discharge (OR =0.47, 95% CI =0.26–0.84). Receiver operating characteristic analysis for prediction of poor stroke outcome showed that the optimal cut-off point of MPV was 8.8 fL (area under the curve 0.586 [0.512–0.659], P=0.03) with a sensitivity of 82.7% and a specificity of 43.9%.Conclusion: Disabling or fatal ischemic stroke in thrombolyzed patients was observed more often in patients with high admission MPV. The prognostic value of MPV was independent of other well-defined individual risk factors. Keywords: acute ischemic stroke, rt-PA, prognosis, MPV, biomarker, platelet activity, reperfusion
format	article
author	Staszewski J Pogoda A Data K Walczak K Nowocień M Frankowska E Stępień A
author_facet	Staszewski J Pogoda A Data K Walczak K Nowocień M Frankowska E Stępień A
author_sort	Staszewski J
title	The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis
title_short	The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis
title_full	The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis
title_fullStr	The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis
title_full_unstemmed	The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis
title_sort	mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with iv thrombolysis
publisher	Dove Medical Press
publishDate	2019
url	https://doaj.org/article/04b7df52796f4474919b79891ac4ce84
work_keys_str_mv	AT staszewskij themeanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT pogodaa themeanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT datak themeanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT walczakk themeanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT nowocienm themeanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT frankowskae themeanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT stepiena themeanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT staszewskij meanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT pogodaa meanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT datak meanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT walczakk meanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT nowocienm meanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT frankowskae meanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis AT stepiena meanplateletvolumeonadmissionpredictsunfavorablestrokeoutcomesinpatientstreatedwithivthrombolysis
_version_	1718403416331386880

The mean platelet volume on admission predicts unfavorable stroke outcomes in patients treated with IV thrombolysis

Ejemplares similares