Abstract Details

Title Higher Coated-Platelet Levels in Patients with Lacunar Stroke are Associated with Lower Cognitive Performance at 3 Months

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) S22 - Stroke Genetics, Cellular Responses, and Animal Models (3:52 PM-4:03 PM)

Poster/Presentation
Number 003

Background Coated-platelets are a subset of highly procoagulant platelets observed upon dual agonist stimulation with collagen and thrombin. Coated-platelet levels are increased in non-lacunar stroke compared to lacunar stroke and healthy controls, and higher levels are associated with stroke recurrence. Previously, we have shown that higher coated-platelet levels in patients with large-artery disease and non-lacunar stroke are associated with lower cognitive scores.

Objective To examine whether coated-platelet levels measured at the time of lacunar stroke correlate with cognitive performance at 3 months following the brain infarction.

Design/Methods Consecutive patients with lacunar stroke were enrolled over 38 months. Coated-platelets were determined at the time of the stroke and reported as percent of platelets converted to coated-platelets. MMSE was recorded during a stroke clinic visit 3 months after hospital discharge. Patients with prior dementia, post-stroke aphasia or interval stroke were excluded. Correlations were calculated between MMSE and coated-platelet levels, demographic variables, education, pertinent medications, vascular risk factors and NIHSS score. Those reaching significance at p≤0.15 were included in a multiple regression analysis model.

Results We enrolled 109 patients, with a mean age of 67.9 years (range 38-100), mean coated-platelet levels of 28.3% (range 5.2-69.3) and mean NIHSS score of 3.7 points (range 0-17). Mean MMSE was 26.3 points (range 20-30). Bivariate associations were observed with age, coated-platelet levels, SSRI use, and race. The resulting best model of MMSE included coated-platelet levels (b=-0.07, P=0.004), age (b=-0.07, P=0.003) and SSRI use (b=-1.92, P=0.009) and explained 25.6% of the variance. No change in coated-platelet levels was noted at 3 months (P=0.59).

Conclusions Three months after lacunar stroke, higher coated-platelet levels, older age and SSRI use were associated with lower cognitive scores. These findings suggest a link between increased platelet procoagulant potential and development of vascular cognitive impairment following lacunar stroke.

Authors/Disclosures
Angelia Kirkpatrick PRESENTER	Angelia Kirkpatrick has nothing to disclose.
Andrea Vincent	Andrea Vincent has received personal compensation for serving as an employee of Vista LifeSciences. The institution of Andrea Vincent has received research support from Medical Technology Enterprise Consortium (MTEC).
Meheroz H. Rabadi, MD, FAAN (Dept of VA Medical Center #127)	No disclosure on file
George Dale	George Dale has nothing to disclose.
Calin I. Prodan, MD (Univ of Oklahoma - Neurology Dept)	The institution of Dr. Prodan has received research support from US Department of Veterans Affairs (Merit award CX000340).

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