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Category: Volume 4 Issue 04 April 2016
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Title: Study of Platelet Functions and Prothrombotic Factors in Cerebrovascular Accidents: A Tertiary Care Centre Experience

Authors: Dr Poonam Rani, Dr Rashmi Kushwaha, Prof. Ashutosh Kumar, Prof. U.S Singh,  Dr Sachil Vohra, Dr Yusuf

 DOI:  http://dx.doi.org/10.18535/jmscr/v4i4.35

Abstract

Introduction: According to WHO, globally cerebrovascular accident is third commonest cause of mortality and fourth leading cause of disease burden. Ischemic cerebrovascular accident is the most common cerebrovascular disease, most often due to atherothrombotic disease and uncommonly by disorder of hyper-coagulation. Disorders of coagulation leading to thrombosis are approximately 1% of all ischemic cerebrovascular accident and 4-8% of young cerebrovascular accident. Similarly combined deficiency lead to hypercoagulable state and rarely present as cerebrovascular accident.[1]

 Aims and Objectives: The present study was undertaken to assess the role of platelet functions (Platelet Count, platelet volume and platelet aggregation) and antithrombotic factors (protein C, protein S and Homocysteine) in the pathogenesis of cerebrovascular accident.

Materials and Methods: A total of 50 patients coming to Neurology emergency with cerebrovascular accidents and 50 age and sex matched controls were included.

The cases and controls included in this study were investigated for following parameters: Protein C and protein S were estimated by Coagulometric Assay, Homocysteine estimation was done by Semi-auto analyser, Platelet count and platelet volume were estimated by automated cell counter, Platelet aggregation with ADP by using optical Aggregometer and for PT/APTT estimation.

 Results: Levels of Protein C and Protein S were significantly decreased whereas Homocysteine was significantly raised in stroke patients.

 Mean platelet Volume was increased and platelet count reduced in ischemic stroke patients. 
Platelet aggregation with 5µM ADP was reduced in ischemic and hemorrhagic stroke. 
Conclusion: Protein C, Protein S, MPV and Homocysteine levels may be useful in diagnosing the ischemic stroke. Platelet count and MPV are inversely proportional to each other in case of ischemic stroke whereas platelet aggregation with 5µM ADP is reduced in both ischemic and hemorrhagic stroke. 
Key words: Cerebral stroke, Risk factors, Platelets; Aggregation; MPV, Ischemia

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Corresponding Author

Dr Rashmi Kushwaha