https://www.sciencedirect.com/science/article/pii/S1052305718301344
Backgrounds
Spontaneous
micro-aggregation of platelets (SMAP) is frequently observed in stroke
patients and is a trigger for the additional development of larger
thrombi. We tested the hypothesis that SMAP may predict clinical outcome
in acute ischemic stroke patients.
Methods and Results
Consecutive
acute ischemic stroke patients (n = 358) who were transferred to our
hospital within 24 hours after its onset were enrolled. Peripheral
venous blood was sampled to measure various parameters when they
arrived. SMAP was correlated with plasma brain natriuretic peptide and
diastolic blood pressure positively, and with serum albumin and body
weight negatively. Multivariable Cox regression analysis showed that
only serum albumin was an independent predictor of the SMAP (P = .0023).
The proportion of patients who were functionally independent (score 0-2
on the modified Rankin Scales) at discharge was lower in the third
tertile of SMAP (higher level) as compared with the first and the second
tertiles in ischemic stroke (odds ratio [OR], 5.76; 95 % confidence
interval [CI], 3.31-10.05; P < .0001) and atherothrombotic stroke (P = .02
by chi-square test). The lower proportion of patients achieving
independence was found in the first tertile of serum albumin (lower
level) as compared with the second and third tertiles in ischemic (OR,
4.60; 95% CI, 2.66-7.95; P < .0001), atherothrombotic, and cardioembolic stroke (P = .004 and P < .0001
by chi-square test). On logistic regression analysis, SMAP and serum
albumin remained independent predictors of poor outcome in ischemic
stroke.
Conclusions
SMAP within 24 hours after stroke onset is a novel independent predictor of clinical outcome in acute ischemic stroke patients.
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