Introduction and Objective: Stroke is one of the leading causes of mortality and long-term disability throughout the world. Mean platelet volume (MPV), a marker of platelet activation, is calculated and provided by automatic blood cell count equipment during routine complete blood count analysis is a surrogate marker of platelet function and a potential mediator of the association between inflammation and thrombosis. So, to investigate MPV in ischaemic stroke and its role to discriminating more severe stroke from mild one the current study was done. Methods: This observational case control study was carried out in Department of Medicine, Dhaka Medical College Hospital (DMCH) from July 2015 to June 2016. 100 patients with attack of ischaemic stroke who presented within 24 hours of symptoms onset were divided into 2 groups (group-1: mRS score 0-2, and group-2: mRS score 3 or more) based on severity. Severity of ischaemic stroke was assessed by the modified Rankin Scale. At the same time 100 age and sex matched controls were taken. Blood samples were collected from both groups and MPV was measured. The results were statistically compared by SPSS 22.0. Statistical significance was accepted at <0.05. Results: The MPV values were more in case group in comparison to control group (10.88±1.23 vs 10.03±1.03; z score-5.31; p value <0.01). Comparison between the 2 groups revealed that MPV value was higher and more significant in group 2 of cases than group 1(10.15± 0.739 in group 1 versus 11.63± 1.04 in group having 2; z score-7.7, p value <0.001). 6 patients of group 2, who could not overcome the situation and died within 24 hours of admission had MPV value of 12.92±0.30. After controlling the risk profiles associated with ischaemic stroke by means of binary logistic regression model, the effect of MPV in ischaemic stroke remained statistically significant (OR: 4.418, 95% CI 2.468-7.908, p= 0.000). ROC curve was 0.85 and standard error 0.039 (95% CI: 0.779-0.932; p<0.01), ...
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