Relationship between platelet functions and recurrent ischemic vascular events in patients with ischemic stroke

Abstract

Objective To investigate the relationship between the platelet functions and the recurrent ischemic vascular events in secondary prevention of ischemic stroke during the follow-up periods. Methods Aspirin was taken from the first day of admission in 350 patients with ischemic stroke within 72 hours. Platelet aggregation ratio measured by PL series platelet function analyzer (PL-11) after 7-10 days and the demographic characteristics were recorded. All patients were followed up for 6 months and the recurrent vascular events were recorded. Logistic regression model was used to estimate the risk factors of vascular events and receiver operating characteristic curve analysis was used to estimate the predictive value of platelet aggregation ratio in recurrent ischemic vascular events. Results Of the 350 patients, 52 patients had ischemic vascular events recurrence and 298 patients did not have recurrence. Ischemic vascular events recurrence group was more likely to be with diabetes (48.08% (25/52) vs 23.15% (69/298), χ2 =14.000, P<0.01), low-density lipoprotein (LDL) cholesterol ((3.02±0.74) mmol/L vs (2.74±0.72) mmol/L, t=2.410, P=0.016), arachadonic acid-induced maximum platelet aggregation ratio (MAR-AA; 27.31%±9.49% vs 18.85%±6.60%, t=6.173, P<0.01), and epinephrine-induced maximum platelet aggregation ratio (MAR-EPI; 61.26%±13.02% vs 51.41%±14.81%, t=4.498, P<0.01). Diabetes, LDL cholesterol, MAR-AA and MAR-EPI were risk factors for recurrent ischemic vascular events. MAR-AA (OR=1.133, 95% CI 1.080-1.188, P<0.01) was closely correlated with ischemic vascular events recurrence during the follow-up period and had a greater predictive value, and the area under the receiver operating characteristic curve was 0.803. MAR-AA was also an independent risk factor for ischemic stroke recurrence (OR=1.090, 95% CI 1.037-1.145, P=0.001). Conclusion Platelet function measured by PL-11 is significantly associated with higher risk of recurrent ischemic vascular events and has a greater predictive value in secondary prevention of ischemic stroke. Key words: Stroke; Brain ischemia; Aspirin; Platelet function; Risk factors