Abstract
BackgroundIschemic stroke (IS) constitutes a relevant health concern recently in younger population causing permanent cognitive and function-limiting disability and ranks as the 3rd cause of death in Egypt after cardiac and hepatic diseases. Platelet activation has a crucial mechanism in arterial thrombogenesis, thus in pathophysiology of IS. Surface expression of P-selectin (CD62P) reflects platelet activation and measured by flowcytometry. The purpose of the study is to evaluate whether platelet activity and reactivity are considered risk factors for IS so more restrict antiplatelet protocols could be implemented for management and recurrence prevention.ResultsStudy population was 60 IS patients and 60 apparently healthy age and gender-matched controls. Patients were subdivided into 37 patients without classical risk factors, aged 46.1 ± 8.2, and 23 patients with > 1 vascular risk factors, aged 52 ± 9.9. The percentage of platelets expressing CD62P reflecting ex vivo baseline activity was significantly higher in stroke patients to controls (p = 0.001), also platelet reactivity (CD62P expression after ADP provocation) was statistically significantly elevated in patients than in controls (p < 0.0001) and was significantly higher in IS patients with vascular risk factors compared to patients without risk factors (p = 0.02).ConclusionBoth baseline platelet activity and reactivity were significantly higher in IS patients, and were also higher in IS patients with other vascular risk factors than in cryptogenic stroke and considered risk factors for IS.
Highlights
Ischemic stroke (IS) constitutes a relevant health concern recently in younger population causing permanent cognitive and function-limiting disability and ranks as the 3rd cause of death in Egypt after cardiac and hepatic diseases
A statistically significant difference was found in White blood cells (WBC), Mean platelet volume (MPV) and Platelet distribution width (PDW) being higher in patients than in controls, but did not significantly differ between patients with and without risk factors subgroups, as well as significantly higher total cholesterol, TG and Low-density lipoproteins (LDL) and significantly lower High-density lipoproteins (HDL) in patients than controls in addition to significantly higher RBS, serum creatinine and TG among patients with vascular risk factors (Tables 2, 3)
The percentage of platelets expressing CD62P reflecting ex vivo baseline activity was significantly higher in stroke patients to controls (32.82 ± 13 vs. 25.77 ± 10, p = 0.001), with mean fluorescent intensity (MFI) in IS patients was 103.6 ± 40.6 compared to 79.1 ± 35.2 in healthy controls, that difference was statistically significant (p = 0.001) (Table 4, Figs. 3, 4), and it was significantly higher in IS patients with vascular risk factors compared to patients without risk factors (34.2 ± 13.7 vs. 30.5 ± 12.4, p = 0.02) (Table 5)
Summary
Ischemic stroke (IS) constitutes a relevant health concern recently in younger population causing permanent cognitive and function-limiting disability and ranks as the 3rd cause of death in Egypt after cardiac and hepatic diseases. The purpose of the study is to evaluate whether platelet activity and reactivity are considered risk factors for IS so more restrict antiplatelet protocols could be implemented for management and recurrence prevention. In North Africa and the Middle East, stroke has become a major health problem, especially in younger population with estimates that deaths attributed to it will nearly double by 2030 [1]. The increasing prevalence of stroke and its risk factors in Egypt are alarming rendering it as an emerging public health problem. Platelet effects are augmenting the growth of an atherosclerotic lesion, and worsening the impact of atherothrombosis [6]. They are loaded with a large array
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