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. 2021 May 24;11(6):469.
doi: 10.3390/life11060469.

Mean Platelet Volume as a Potential Marker of Large Vessel Occlusion and Predictor of Outcome in Acute Ischemic Stroke Patients Treated with Reperfusion Therapy

Aleksander Dębiec  1 , Aleksandra Pogoda-Wesołowska  1 , Piotr Piasecki  2 , Adam Stępień  1 , Jacek Staszewski  1
Affiliations

Mean Platelet Volume as a Potential Marker of Large Vessel Occlusion and Predictor of Outcome in Acute Ischemic Stroke Patients Treated with Reperfusion Therapy

Aleksander Dębiec et al. Life (Basel). .

Abstract

(1) Background: An early diagnosis of a large vessel occlusion (LVO) is crucial in the management of the acute ischemic stroke (AIS). The laboratory predictors of LVO and a stroke outcome remain unknown. We have hypothesized that high MPV-a surrogate marker of the activated platelet-may be associated with LVO, and it may predict a worse AIS outcome. (2) Methods: This was a retrospective study of 361 patients with AIS who were treated with thrombolysis (tPA, 65.7%) and/or mechanical thrombectomy (MT, 34.3%) in a tertiary Stroke Center between 2011 and 2019. (3) Results: The mean MPV in the cohort was 9.86 ± 1.5 fL (1st-4th quartiles: <8.8, >10.80 fL). Patients in the 4th quartile compared to the 1st had a significantly (p < 0.01) more often incidence of an LVO related stroke (75% vs. 39%) and a severe stroke manifestation with a higher RACE score (5.2 ± 2.8 vs. 3.3 ± 2.4), NIHSS at baseline (mean ± SD, 14 ± 6.5 vs. 10.9 ± 5.2), and NIHSS at discharge (6.9 ± 7 vs. 3.9 ± 3.6). A multivariate analysis revealed that quartiles of MPV (OR 1.4; 95%CI 1.2-1.8) significantly predicted an LVO stroke, also after the adjustment for RACE < 5 (OR 1.4; 95%CI 1.08-1.89), but MPV quartiles did not predict a favorable stroke outcome (mRS ≤ 2) (OR 0.89; 95%CI 0.7-1.13). (4) Conclusion: Our data suggest that MPV is an independent predictor of LVO in patients with an acute ischemic stroke.

Keywords: large vessel occlusion; mean platelet volume (MPV); mechanical thrombectomy; stroke; thrombolysis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Baseline NIHSS (a), RACE (b) scores, and delay from stroke onset to blood sample (c) by MPV quartiles. One-way analysis of variance (ANOVA) by ranks.
Figure 2
Figure 2
Multivariate analysis of factors related to large vessel occlusion (LVO).
Figure 3
Figure 3
ROC curves for various cut-off levels of RACE and MPV in differentiating between LVO and non-LVO related ischemic strokes.
See this image and copyright information in PMC

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