Differential Diagnosis of Stroke by Platelet Large Cell Ratio (P-LCR) Levels

Abstract

Aim: Platelets play an important role in the pathogenesis of thrombosis and atherosclerosis. Platelet Large Cell Ratio (P-LCR), a routine hemogram parameter, is the largest fraction of platelets that are more closely related to thrombotic events. In this study, for the first time in the literature, P-LCR levels in ischemic and hemorrhagic stroke patients were compared with the levels in transient ischemic attack (TIA) group. Method: Retrospectively, hospital records between January 2016 and 2019, were searched by ICD-10 codes, and patients aged between 18-70 years who were diagnosed as ischemic stroke, hemorrhagic stroke and transient ischemic attack were included. The P-LCR test results in the first hemogram test of the patients taken at the time of admission to the hospital were included and compared. Results: Of the 4511 patients, 92.6% (n=4177) were diagnosed with ischemic stroke, 6% (n=271) with hemorrhagic stroke, and 1.4% (n=63) of patients with TIA. The P-LCR levels of the ischemic and hemorrhagic stroke patients were found to be significantly higher than the TIA group (p=0.027; p=0.044, respectively). The Area Under the Curve (AUC) values for ischemic, hemorrhagic and total stroke versus TIA patients were 0.581, 0.568, and 0.580; respectively. The cut-off value of P-LCR was 26.65 ng/L between the ischemic stroke and TIA. Conclusion: The increase in P-LCR levels can be used to distinguish ischemic and hemorrhagic stroke from TIA.