Influence of lipoprotein-associated phospholipase A2 mass on prognosis value of baseline platelet count for clinical outcomes after acute ischemic stroke

Suwen Shen; Chongke Zhong; Aili Wang; Liyuan Han; Zhengbao Zhu; Yanbo Peng; Hao Peng; Daoxia Guo; Xiaowei Zheng; Tan Xu; Jing Chen; Zhong Ju; Deqin Geng; Yonghong Zhang; Jiang He

doi:10.1016/j.atherosclerosis.2020.06.022

Influence of lipoprotein-associated phospholipase A₂ mass on prognosis value of baseline platelet count for clinical outcomes after acute ischemic stroke

Atherosclerosis. 2020 Aug:306:50-56. doi: 10.1016/j.atherosclerosis.2020.06.022. Epub 2020 Jul 6.

Authors

Suwen Shen¹, Chongke Zhong², Aili Wang¹, Liyuan Han³, Zhengbao Zhu⁴, Yanbo Peng⁵, Hao Peng¹, Daoxia Guo¹, Xiaowei Zheng¹, Tan Xu¹, Jing Chen⁶, Zhong Ju⁷, Deqin Geng⁸, Yonghong Zhang⁹, Jiang He⁶

Affiliations

¹ Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.
² Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA. Electronic address: ckzhong@suda.edu.cn.
³ Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, China.
⁴ Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China; Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
⁵ Department of Neurology, Affiliated Hospital of North China University of Science and Technology, Tangshan, China.
⁶ Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA; Department of Medicine, Tulane University School of Medicine, New Orleans, LA, USA.
⁷ Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Tongliao, China.
⁸ Department of Neurology, Affiliated Hospital of Xuzhou Medical College, Xuzhou, China.
⁹ Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China. Electronic address: yhzhang@suda.edu.cn.

PMID: 32688104
DOI: 10.1016/j.atherosclerosis.2020.06.022

Abstract

Background and aims: We aimed to examine the association between baseline platelet count (PLT) and prognosis of acute ischemic stroke according to lipoprotein-associated phospholipase A₂ (Lp-PLA₂) mass.

Methods: A total of 3254 patients with acute ischemic stroke were included in this analysis. The primary outcome was a combination of major disability and all-cause mortality (modified Rankin Scale score ≥3) at 3 months after stroke. Secondary outcome was major disability and all-cause mortality, respectively.

Results: The prognosis value of PLT for primary outcome was significantly modified by Lp-PLA₂ mass (p_interaction = 0.002). After multivariate adjustment, elevated PLT was associated with the increased risk of primary outcome in patients with high Lp-PLA₂ mass (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.09-2.48; p_trend = 0.002), but not in those with low Lp-PLA₂ mass (OR, 0.94; 95%CI, 0.62-1.42; p_trend = 0.181), when comparing two extreme PLT quartiles. A similar association was found between elevated PLT and major disability (p_interaction = 0.001). Elevated PLT was associated with increased risk of major disability only in patients with high Lp-PLA₂ mass (OR, 1.54; 95%CI, 1.03-2.31; p_trend = 0.007), for the highest quartile vs the lowest quartile. Each 100 × 10⁹/L increment in PLT was associated with 42% (95%CI, 12%-79%) increased risk of primary outcome and 33% (95%CI, 6%-68%) increased risk of major disability in those with high Lp-PLA₂ mass.

Conclusions: The elevated PLT was associated with poor prognosis of acute ischemic stroke only in patients with high Lp-PLA₂ mass. Lp-PLA₂ might be an important factor influencing the prognosis value of PLT for clinical outcomes in acute ischemic stroke patients.

Keywords: Acute ischemic stroke; Clinical outcomes; Lipoprotein-associated phospholipase A(2) mass; Platelet count; Prognosis value.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

1-Alkyl-2-acetylglycerophosphocholine Esterase* / pharmacology
Biomarkers
Brain Ischemia* / diagnosis
Humans
Ischemic Stroke* / drug therapy
Platelet Count*
Prognosis
Risk Factors
Stroke* / diagnosis

Substances

Biomarkers
1-Alkyl-2-acetylglycerophosphocholine Esterase