Title: Mean Platelet Volume in Patients with Acute Ischemic Stroke: A Case Control Study
Authors: Dr Ritu Gupta, Dr Sandeep Singh, Dr Tarunendra Kumar Mishra
DOI: https://dx.doi.org/10.18535/jmscr/v6i7.176
Abstract
Background: Cerebrovascular diseases (CVD) include some of the most common and devastating disorders. The important risk factors are hypertension, heart disease, atrial fibrillation, diabetes mellitus, cigarette smoking, and hyperlipidemia. In this context platelets play a crucial role in the pathogenesis of atherosclerotic complications, contributing to thrombus formation. Platelet size found to be elevated in individuals with hypertension and diabetes mellitus. Platelet size (mean platelet volume, MPV) is a marker and possibly determinant of platelet function.
Aims & Objectives: To determine mean platelet volume (MPV) and it’s correlation with Ischemic stroke/TIA and role in severity of stroke.
Material and Methods: The study was a prospective case-control study conducted at tertiary care centre Jabalpur, including 50 cases and 50 controls.
Results: In this study MPV was found to be higher in older age group among cases and control.MPV is found to be higher in patients of Ischemic stroke as compare to controls. Comparing cases and control with respect to smoking shows significant high MPV among cases who smoke. Maximum no. cases with hypertension had MPV 9-10.9 fl. This finding is statistically significant suggesting that hypertension is associated with high MPV. Total 12 cases had MPV 11-12.9 with higher Rankin severity score (RSS).
Conclusion: Mean platelet volume (MPV) as a risk factor in cases of coronary artery disease is well known.MPV is higher in patients of acute ischemic stroke / TIA and is associated with more severe morbidity in patients with acute ischemic stroke / TIA.
Keywords: CVD- Cerebrovascular diseases, MPV -mean platelet volume, TIA- Transient ischemic attack, RSS-Rankin severity score, AIS-acute ischemic stroke.
References
- Smith WS, English JD, Johnson SC. Cerebrovascular diseases. Harrison‘s Principles of Internal Medicine. Ed. Fauci AS, Braunwald E, Kasper DL, Hauser SL, Longo DL, Jameson JL et al 17th ed. McGraw Hill ; Volume 2;2513-2535.
- PK Sethi. Stroke - Incidence in India and management of ischaemic stroke. Neurosciences Today; Vol VI no 3. July -September. 2002.
- Victor M, Ropper AH, Adams RD. Cerebrovascular diseases. Adam‘s and Victor‘s Principles of Neurology. Ed. Ropper A H,Samuels MA. 9th ed. United States of America, McGraw Hill 2009.
- Pathansali R, Smith NM, BathPM. Prothrombotic megakaryocyte and platelet changes in hypertension are reversed following treatment: a pilot study. Blood 2001;12:144-149.
- Greisenegger S, Endler G, Hsieh K, Tentschert S, Mannhalter C, Lalouschek W. Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebro-vascular events? Stroke 2004;35:1688–91.
- Smith N, Pathansali R, Bath P. Platelets and stroke. Vascular medicine 1999; 4:165-172.
- Rankin J. ―Cerebral vascular accidents in patients over the age of 60.‖ Scott Med J 1957; 2:200-215.
- Bonita R, Beaglehole R. ―Modification of Rankin Scale: Recovery of motor function after stroke.‖ Stroke 1988 ; 19(12):1497-1500.
- Durdu Tamer et al; Ankara, Turkey. Published, JPMA Dec 13.
- Philip Bath et al; J stroke cerebrovasc Dis 2010 Jan 19(1), 66-72.
- Coban E, Yazicioglu G, Berkant A A, Akcit F. The Mean Platelet Volume in patients with essential and white coat hypertension. Platelets. 2005; 16(7):435-438.
- Lippi G, Salvagno GL, Targher G and Guidi GC. Relationship between Mean Platelet Volume and Bichemical Components of metabolic syndrome. Clin DrugInvest 2007; 27 (10): 731-732.
- Greisenegger S, Endler G, Hsieh K, Tentschert S, Mannhalter C, Lalouschek W. Is elevated mean platelet volume associated with a worse outcome in patients with acute ischemic cerebro-vascular events? Stroke 2004;35:1688–91.