Prognostic role of mean platelet volume and platelet count in ischemic and hemorrhagic stroke

Abstract

Background: Mean platelet volume (MPV) is an indicator of platelet function or reactivity. Platelets play an important role in the pathophysiology of ischemic stroke but the effect of platelet count (PC) and dysfunction in the pathogenesis of hemorrhagic stroke is poorly understood. We have investigated the possibility of MPV and PC being an independent risk factor of ischemic and haemorrhagic stroke and their effect on prognosis.

Methods: We prospectively studied 692 patients with either ischemic or hemorrhagic stroke and compared them with 208 control subjects with similar risk factors, but without evidence of vascular events. The association of MPV and PC with cause, localization, and size of the infarct or hemorrhage was examined. Prognosis was determined by Glasgow Outcome Scale. By multivariate logistic regression analysis, the influence of MPV and PC on stroke subtype and prognosis was determined.

Results: MPV and PC were observed as independent risk factors for ischemic stroke (P = .007, odds ratio [OR] = 0.866; P = .000, OR = 0.996; 95% confidence interval [CI], respectively). There was a negative and significant correlation between PC and hemorrhagic stroke (P = .001), but no association was found with MPV (P > .05). MPV and PC were not statistically significant related to etiological subgroups, localization, and size of the infarct or hemorrhage (P > .05). Ischemic group MPV (P = .013, OR = 1.02, 95% CI) and hemorrhagic group PC were in correlation with worse outcome (P = .001, OR = 1.004, 95% CI).

Conclusion: MPV, may be an early and important predictor for the prognosis of ischemic stroke, whereas for hemorrhagic stroke PC has a role for outcome.